J Hepatology: 恩替卡韦与替诺福韦治疗慢性乙型肝炎的疗效分析

2019-09-12 不详 MedSci原创

目前尚不清楚哪种抗病毒药物恩替卡韦(ETV)或替诺福韦地索普西富马酸盐(TDF)对于改善慢性乙型肝炎(CHB)患者的预后是有利的。因此,本项研究旨在评估这两种抗病毒药物在治疗CHB患者中预防肝病进展的能力。

背景与目的
目前尚不清楚哪种抗病毒药物恩替卡韦(ETV)或替诺福韦地索普西富马酸盐(TDF)对于改善慢性乙型肝炎(CHB)患者的预后是有利的。因此,本项研究旨在评估这两种抗病毒药物在治疗CHB患者中预防肝病进展的能力。

方法
研究人员从4所教学医院招募了接受过ETV或TDF作为一线抗病毒药物治疗的初治CHB患者。入选时失代偿期肝硬化或肝细胞癌(HCC)患者被排除在外。主要观察结果是HCC和死亡或原位肝移植(OLT)的累积发生概率。

结果
本项研究总共招募了2897名患者(ETV和TDF组分别为1484名和1413名)。ETV和TDF组之间的年度HCC发生率无统计学差异(分别为1.92 VS 1.69 / 100人年[p = 0.852])。倾向评分(PS) - 治疗加权(ITPW)分析的匹配和反向概率产生相似的结果(分别为HR 1.021 [ p= 0.884]和0.998 [p= 0.988])。ETV和TDF组的年死亡率或OLT发生率无统计学差异(分别为0.52 和 0.53 / 100 PY; [p= 0.451])。

结论
本项研究表明在ETV和TDF在治疗慢性乙型肝炎预防HCC和死亡或OLT方面的总体效果没有统计学差异。

原始出处:

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    2019-09-14 gwc384
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    2019-09-12 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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J Viral Hepat:对阿德福韦单一治疗应答不佳,再使用以阿德福韦为基础的联合治疗后的有效性和安全性

相比LAM + ADV 和ETV + ADV组,LdT + ADV组患者eGFR有一定改善。 研究结论:这三种组合策略都能很好地控制病毒的复制,但是LdT + ADV联合治疗可能会提高HBeAg血清转化和改善eGFR。

Hepatol Res:在日本CHB患者中,早期从恩替卡韦治疗转换到聚乙二醇干扰素的序贯治疗,结果并不令人满意

在日本CHB患者中,早期从恩替卡韦治疗转换到聚乙二醇干扰素的序贯治疗,结果并不令人满意。除了病毒因素外,宿主代谢特征和肝纤维化/肿瘤标志物可以用来预测对治疗的持续反应,但准确预测治疗反应是困难的。

J Hepatol:接受核苷酸类似物治疗的CHB患者中,治疗后血清ALT达到正常水平,可较少肝脏相关事件。

在接受治疗的CHB患者中,血清ALT达到正常水平后,可改善患者临床结果。