替诺福伟2009年开始服用情况更新 12个周DNA不可测

时光机器人

美利坚，不错啊～

efeee

此生投错胎了，真希望地球能裂变出一个洞，让我们掉到美国去。

tyxfxvv

爱妻大元帅 发表于 2009-12-31 11:21
是初始治疗。在美国，替诺福韦是乙肝首选药物，的确准备长期抗战。在美国一个月
30粒替诺福韦售价650美元， ...

请问楼主，我现在在服用拉米加阿德，这两种药在美国有医保的话是否能报呢？按百分之多少报呢？还有如果以后想换替诺福韦可以吗？多谢楼主！

厚黑教主

回复 efeee 的帖子

咱们一起去，起码活得像人。

爱妻大元帅

回复 tyxfxvv 的帖子

在美国，如果你有一份正常的工作，工作带有医疗保险，那么，只要凭医生的处方，
你去配药时，你就只需要交你的10到25美元的自己承担部分，其余部分是药店会直
接向保险公司收取。我从来不报销的，都是这样操作的。

在美国生活了十几年后，我们已经回到了中国我们带回来10个月的药，
回国后就全部自费了。我们做出这样的选择是应为我们有这个条件。以后我们每年
要到美国去弄药。

爱妻大元帅

美国的替诺福韦第四年的临床结果出来了，跟踪下来，初始用药者，四年下来，产生
抗药的发生率是0%。

- New Long-Term Data Also Show Significant "s" Antigen Loss in Key
Patient Population -
Oct. 30, 2010 (Business Wire) -- Gilead Sciences, Inc. (Nasdaq: GILD) today announced new data from the open-label phase of two pivotal Phase III clinical trials (Studies 102 and 103) evaluating the four-year efficacy of Viread® (tenofovir disoproxil fumarate) for the treatment of chronic hepatitis B virus (HBV) infection. Significantly, no resistance to Viread emerged over 192 weeks of treatment, and 10.8 percent of patients receiving Viread in Study 103 (HBeAg-positive) for four years experienced surface, or “s”, antigen (HBsAg) loss, which is a marker of the resolution of chronic HBV infection. Additional data from these studies and from Study 106 show the durable antiviral efficacy of Viread among several key patient subpopulations, including patients with high baseline viral levels, individuals of Asian descent and treatment-experienced patients. These findings are being presented at the 61st annual meeting of the American Association for the Study of Liver Diseases (The Liver Meeting 2010) in Boston.

“The complete absence of Viread-related resistance detected among study participants shows that this therapy has a high and durable barrier to viral resistance, which is essential for the long-term success of HBV therapy,” said Patrick Marcellin, MD, of Hôpital Beaujon in Clichy, France, INSERM CRB3 and University of Paris Denis Diderot, and the principal investigator of Study 102. “These four-year results underscore the long-term benefits of Viread for diverse patient populations, including those who are difficult to treat.”

The 192-week data from Studies 102 and 103 evaluate the intent-to-treat population (with the exception of those who left the study for administrative reasons). In Studies 102 and 103, the majority of patients who received Viread for up to 192 weeks experienced sustained suppression of HBV DNA levels in the blood below 400 copies/mL and normalization of alanine aminotransferase (ALT, an enzyme that serves as a measure of liver damage). Notably, no HBV pol/RT amino acid substitutions associated with tenofovir resistance were detected through 192 weeks of Viread.

Among HBeAg-positive patients, 29 percent (based on observed data at week 192) experienced “e” antigen seroconversion, which is defined as both the disappearance of the hepatitis B “e” antigen, a marker of HBV replication (rendering the patient “HBe-antigen negative”), and the appearance of antibodies to this antigen (making the patient “HBe-antibody positive”). Additionally, among HBeAg-positive patients receiving Viread through 192 weeks, the cumulative probability (estimated by Kaplan-Meier) of “s” antigen loss, suggesting that HBV infections may have cleared completely, was 10.8 percent.

“Over the years, physicians have come to understand the critical role of ‘s’ antigen loss in the cessation of disease activity,” said Jenny Heathcote, MD, of the University of Toronto, Canada, and the principal investigator for Study 103. “The 10.8 percent ‘s’ loss observed in this trial is a significant finding that makes Viread a highly attractive treatment option for HBV.”

Viread for HBV was approved by the U.S. Food and Drug Administration (FDA) in 2008 and has since become the most-prescribed HBV medicine in the United States. It is the only recommended first-line therapy for hepatitis B to demonstrate continuous efficacy and safety through four years in pivotal studies. In October 2010, the FDA expanded Viread’s indication to include the treatment of chronic hepatitis B among patients with decompensated liver disease, the end stage of hepatitis B in which liver function is marginal and clinical complications frequently occur. Decompensated liver disease is an indication for consideration of liver transplantation.

Viread Data at The Liver Meeting

Studies 102 and 103 are both multi-center, randomized, double-blind Phase III clinical trials comparing Viread to Hepsera® (adefovir dipivoxil) among HBeAg-negative presumed pre-core mutant (Study 102; n=375) and HBeAg-positive (Study 103; n=266) chronic hepatitis B patients with compensated liver disease. Patients had HBV DNA (viral load) above 100,000 copies/mL and elevated levels of ALT upon study initiation. The majority of patients were treatment-naïve, although some patients had prior lamivudine treatment experience. Patients originally randomized to Hepsera in both studies rolled over to open-label Viread treatment (n=196) at week 48, while patients originally randomized to Viread continued open-label Viread (n=389). After 72 weeks, patients with confirmed viremia (HBV DNA levels at or above 400 copies/mL on two consecutive visits) had the option of adding emtricitabine treatment by substituting Truvada® (emtricitabine and tenofovir disoproxil fumarate) for Viread. The number of patients entering year four was 218 (Study 102) and 130 (Study 103) for those originally randomized to receive Viread and 109 (Study 102) and 71 (Study 103) for those originally randomized to receive Hepsera.

Overall Efficacy and Safety at Week 192 (Abstracts 476 and 477)

In an on-treatment analysis, 99 percent of patients in Study 102 and 96 percent of patients in Study 103 who were originally randomized to receive Viread through 192 weeks achieved viral suppression below 400 copies/mL. Among those who were originally randomized to receive Hepsera, 100 percent of patients in Study 102 and 99 percent of patients in Study 103 achieved viral suppression below 400 copies/mL. In an analysis in which the addition of emtricitabine equals failure, 84 percent and 68 percent of patients (Studies 102 and 103, respectively) originally randomized to receive Viread and 87 percent and 72 percent of patients (Studies 102 and 103, respectively) originally randomized to receive Hepsera experienced sustained viral suppression. The majority of patients with elevated ALT at baseline achieved normalized ALT on treatment (ranging from 77 percent to 86 percent across both arms in both studies). Viread was well-tolerated in both studies. During the open-label period (week 48 through week 192), seven patients discontinued treatment due to an adverse event. Creatinine levels, an indicator of kidney function, remained stable through 192 weeks.

Patients with High Viral Load (Abstract 137)

In a subgroup analysis pooling data from Studies 102 and 103, 71 percent of patients who entered the trials with high viral levels (HBV DNA of at least 9 log10 copies/mL) (n=129), achieved sustained viral suppression after 192 weeks of Viread treatment. Of 29 patients who opted to add emtricitabine treatment after 72 weeks due to confirmed viremia, 20 had viral suppression at week 192. At week 192, ALT levels were normalized in 77 percent of patients with high viral load at baseline. Among HBeAg-positive patients (n=118) in this group, 35 percent achieved HBeAg loss and 23 percent experienced HBeAg seroconversion. Overall, 15 percent of patients with high viral load experienced HBsAg loss.

Patients of Asian Descent (Abstract 481)

In another subgroup analysis pooling four-year data from Studies 102 and 103, 77 percent of Asian patients achieved sustained viral suppression (163 patients entered the open-label study phase). Of seven Asian patients who added emtricitabine treatment during the study, four of six remaining on study had viral suppression at week 192. ALT levels normalized in 86 percent of Asians after 192 weeks on treatment. Of 65 HBeAg-positive Asian patients with week 192 serology results, 35 percent achieved HBeAg loss and 26 percent experienced HBeAg seroconversion. Viread was well tolerated among this group of patients. During the open-label phase of Viread treatment, serious adverse events occurred in 6 percent of Asian patients, while grade 3-4 laboratory abnormalities occurred in 15 percent. During the study, one Asian patient had a confirmed serum phosphorus level less than 2 mg/dL, which normalized by week 192, and another had a confirmed increase of at least 0.5 mg/dL in serum creatinine.

周公

什么时候朝鲜打韩国，美国佬帮拖，中国支援，打死美国佬，我们一起去美国进行三光政策，把药都抢光、吃光、烧光

结果都一样

lualu 发表于 2010-5-6 20:41
简直放屁！！！！目前急着等着吃么替诺福维的人基本是那些拉米和阿德还有恩替耐药甚至是因此变异的病患者 ...

不对！坛子里许多战友都彷徨在是否抗病毒之间，我就是其中的一个。由于担心耐药，迟迟未敢下手。你多次出言不逊，思维混乱，恶语伤人，缺乏教养。是一个彻头彻尾，地地道道的人渣！

爱妻大元帅

初始用药，绝对重要，不要一路用药培养病毒的抗药性。

lvlv2000

我是在加拿大，可是我发病是上个月在中国，吃的是恩替卡韦。不知道恩替和替诺福维有区别吗？哪种更好。我吃恩替的效果也蛮好的。30天从10的6次方到10的3次方。转氨酶从200左右到基本正常。刚回来，今天才看了专科医生的助手。问了她这个药是否是一线药。她说我选药还是对了的。其实中国也有中国k看病的优势。中国看病虽然要钱，但是很方便，想看哪个医生由你定。在国外就很被动，你没有选择权，一切由他们安排，要看一个专科医生要等很久。还好，HBV这个病在国外很重视，我化验结果一出来，马上他们就电话通知我，问我很多问题，家里人的情况，然后寄了家庭成员的化验单给我，让家里人去化验，打预防针。马上让我去做B超。这两天在肝癌讨论区看了很多帖子，心里很难受，我是流着泪看了很多的帖，很心疼那些鲜活的生命就这样被可恶的病魔夺去。这两天我觉也没有睡好，看多了帖子，今天我还专门问了一下医生助手，乙肝容易发展成肝癌吗，我问她见没有见过，她说她从没有遇到过肝癌病人，她也是在这行干了很多年的了，有60多岁了。安慰我不用怕，发展肝癌的很少。最后还拥抱我。在加拿大看病不用花钱，可是买药还是得自己掏钱，我的药现在还是中国带来的，接下来我也不知道是在这儿买还是国内寄，还没有想好。不过今天医生助手说单位一般都买了保险的。买了保险就可以报销。 有哪位是在加拿大的知道怎么买药报销的吗。