Hepatology:glecaprevir和pibrentasvir在HCV基因1型感染及有DAA用药史的患者中治疗12周的效果评估

2017-06-01 MedSci MedSci原创

对于慢性HCV感染,直接作用抗病毒(DAA)治疗尽管已经表现出高SVR率,但仍会发生病毒学的失败,并且会导致潜在病毒耐药,这可能降低后续治疗的有效性。先前使用DAA方案治疗失败的患者,特别是使用过非结构蛋白5A抑制剂的患者的再治疗方案是有限的,目前这一领域的研究仍然未满足医疗需求。近来美国学者发表研究性文章于Hepatology,2期开放标记的研究(MAGELLAN-1)评估对于DAA治疗失败的H

对于慢性HCV感染,直接作用抗病毒(DAA)治疗尽管已经表现出高SVR率,但仍会发生病毒学的失败,并且会导致潜在病毒耐药,这可能降低后续治疗的有效性。先前使用DAA方案治疗失败的患者,特别是使用过非结构蛋白5A抑制剂的患者的再治疗方案是有限的,目前这一领域的研究仍然未满足医疗需求。

近来美国学者发表研究性文章于Hepatology,2期开放标记的研究(MAGELLAN-1)评估对于DAA治疗失败的HCV基因1型感染患者,使用glecaprevir(GLE)+ pibrentasvir(PIB)+利巴韦林(RBV)的有效性和安全性。

总共50例无肝硬化的患者,将其随机分为3组,分别给予200 mg GLE + 80 mg PIB(A组),300 mg GLE + 120 mg PIB +每日一次800 mg RBV(B组)或300 mg GLE + 120 mg PIB+RBV(C组)。通过意向治疗分析,A B C组治疗后第12周SVR分别达到100%(6/6,95%置信区间61-100),95%(21/22,95%置信区间78-99)和86%(19/22,95%置信区间67-95)。A组中没有患者发生病毒学的失败,而B组和C组中分别有1例患者发生病毒学的失败(C组中有两例患者失去随访)。大多数不良反应程度轻微,且没有观察到与研究药物相关的严重不良事件。丙氨酸氨基转移酶、总胆红素或血红蛋白也无实验室检测异常。

对于HCV基因1型感染和先前DAA治疗失败的患者GLE和PIB组合使用具有高度有效性及良好耐受性。 同时服用RBV并不提高治疗的有效性。

原始出处:Poordad F ,et al. Glecaprevir and pibrentasvir for 12 weeks for hepatitis C virus genotype 1 infection and prior direct-acting antiviral treatment.
Hepatology. 2017 Jan 27. doi: 10.1002/hep.29081. [Epub ahead of print]

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    2017-11-24 smlt2008
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    2017-06-03 ymljack
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    2017-06-03 qingting
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    2017-06-03 gwc384

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