优选干扰素VS核苷类似物
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– 24-week off-treatment follow-up
HBeAg Seroconversion (%)
50
P < .001
40
32
30
27
20
10
P = .023
24 27
20 19
End of treatment (Week 48)
Off-treatment follow-up (Week 72)
21
20
17
12
10
3-5
0 PegIFN
0 TBV
2
0
0
ETV
LAM
ADV
Lau G, et al. N Engl J Med. 2005;352:2682-2695. Janssen H, et al. Lancet . 2005;365:123-129. Dienstag J, et al. N Engl J Med. 1999;341:1256-1263. Baraclude [package insert]. Tyzeka [package insert]. Hepsera [package insert]. Chang TT, et al. N Engl J Med. 2006;354:1001-1010. Perrillo RP, et al. N Engl J Med. 1990;323:295-301. Lok AS, et al. Gastroenterology. 1987; 92: 1839-1843.
Applying the Updated Practice Guidelines to the Management of Hepatitis B
干扰素VS核苷类似物
clinicaloptions.com/hep
Magnitude of HBV DNA Decline Does Not Predict HBeAg Outcome
HBeAg Seroconversion (%) HBsAg loss (%)
Data from individual studies, not direct comparisons
40
(different populations, baseline values)
30
22-27
23
HBeAg seroconversion HBsAg loss
-2
-4
-4.5
-6
-5.8
-8
Fried M, et al. EASL 2005. Abstract 488.
60
P < .01
40
32
19 20
0 PegIFN alfa-2a
LAM
HBeAg Seroconversion Rates Over Time With Peginterferon
▪ HBeAg+ patients received pegIFN alfa-2a 180 ug/week, pegIFN + LAM 100 mg/day or LAM for 48 weeks (N = 814)
Outcomes at Long-term Follow-up
Responders Nonresponders
P = .0001
100 P = .0001 86
80
72
60
53*
100
P < .001
86
65
Percentage
▪ Analysis reviewed long-term 40
outcomes in responders and 20
Long-term Follow-up After Interferon Therapy: Rotterdam Experience
▪ 165 HBeAg-positive patients treated with IFN
– 75% of white race – Median follow-up: 8.8 years (range: 0.3-24.0)
0
PegIFN
PegIFN + LAM
(n = 271)
(n = 271)
Lau GK, et al. N Engl J Med. 2005;352:2682-2695.
LAM (n = 272)
Loss of HBsAg, HBeAg Seroconversion After 1 Year of Treatment
Baidu Nhomakorabea
nonresponders
8
11
– Mean follow-up time: 6.2 years (range: 1-11)
0 Normal HBV DNA HBeAg HBsAg ALT Negative Negative Negative (PCR) *P value not provided
Lau DT, et al. Gastroenterology. 1997:113;1660-1667.
HBsAg and HBeAg Loss During Follow-up According to Genotype
▪ HBeAg+ patients treated for 32 weeks with pegIFN alfa-2b 100 μg/week ± LAM 100 mg/day, then pegIFN 50 ug/week ± LAM for 20 weeks
10
1 Untreated
Long-term Follow-up After Interferon Therapy: NIH Experience
▪ 103 patients received interferon between 1984-1991
– 30% were responders (lost HBeAg and HBV DNA [by bDNA assay])
▪ HBsAg loss at follow-up
– 52% of responders – 9% of nonresponders
▪ HBsAg loss followed HBeAg seroconversion
van Zonnenveld M, et al. Hepatology. 2004:39;804-810.
Week 48 HBV DNA Reduction (On treatment)
2
PegIFN alfa-2a 0
LAM
HBeAg Seroconversion 24 Weeks Posttreatment 100
80
Mean HBV DNA Reduction (log10 copies/mL)
Percentage of Patients
HBeAg Seroconversion (%)
50
P < .001
40
32
30
27
20
10
P = .023
24 27
20 19
End of treatment (Week 48)
Off-treatment follow-up (Week 72)
21
20
17
12
10
3-5
0 PegIFN
0 TBV
2
0
0
ETV
LAM
ADV
Lau G, et al. N Engl J Med. 2005;352:2682-2695. Janssen H, et al. Lancet . 2005;365:123-129. Dienstag J, et al. N Engl J Med. 1999;341:1256-1263. Baraclude [package insert]. Tyzeka [package insert]. Hepsera [package insert]. Chang TT, et al. N Engl J Med. 2006;354:1001-1010. Perrillo RP, et al. N Engl J Med. 1990;323:295-301. Lok AS, et al. Gastroenterology. 1987; 92: 1839-1843.
Applying the Updated Practice Guidelines to the Management of Hepatitis B
干扰素VS核苷类似物
clinicaloptions.com/hep
Magnitude of HBV DNA Decline Does Not Predict HBeAg Outcome
HBeAg Seroconversion (%) HBsAg loss (%)
Data from individual studies, not direct comparisons
40
(different populations, baseline values)
30
22-27
23
HBeAg seroconversion HBsAg loss
-2
-4
-4.5
-6
-5.8
-8
Fried M, et al. EASL 2005. Abstract 488.
60
P < .01
40
32
19 20
0 PegIFN alfa-2a
LAM
HBeAg Seroconversion Rates Over Time With Peginterferon
▪ HBeAg+ patients received pegIFN alfa-2a 180 ug/week, pegIFN + LAM 100 mg/day or LAM for 48 weeks (N = 814)
Outcomes at Long-term Follow-up
Responders Nonresponders
P = .0001
100 P = .0001 86
80
72
60
53*
100
P < .001
86
65
Percentage
▪ Analysis reviewed long-term 40
outcomes in responders and 20
Long-term Follow-up After Interferon Therapy: Rotterdam Experience
▪ 165 HBeAg-positive patients treated with IFN
– 75% of white race – Median follow-up: 8.8 years (range: 0.3-24.0)
0
PegIFN
PegIFN + LAM
(n = 271)
(n = 271)
Lau GK, et al. N Engl J Med. 2005;352:2682-2695.
LAM (n = 272)
Loss of HBsAg, HBeAg Seroconversion After 1 Year of Treatment
Baidu Nhomakorabea
nonresponders
8
11
– Mean follow-up time: 6.2 years (range: 1-11)
0 Normal HBV DNA HBeAg HBsAg ALT Negative Negative Negative (PCR) *P value not provided
Lau DT, et al. Gastroenterology. 1997:113;1660-1667.
HBsAg and HBeAg Loss During Follow-up According to Genotype
▪ HBeAg+ patients treated for 32 weeks with pegIFN alfa-2b 100 μg/week ± LAM 100 mg/day, then pegIFN 50 ug/week ± LAM for 20 weeks
10
1 Untreated
Long-term Follow-up After Interferon Therapy: NIH Experience
▪ 103 patients received interferon between 1984-1991
– 30% were responders (lost HBeAg and HBV DNA [by bDNA assay])
▪ HBsAg loss at follow-up
– 52% of responders – 9% of nonresponders
▪ HBsAg loss followed HBeAg seroconversion
van Zonnenveld M, et al. Hepatology. 2004:39;804-810.
Week 48 HBV DNA Reduction (On treatment)
2
PegIFN alfa-2a 0
LAM
HBeAg Seroconversion 24 Weeks Posttreatment 100
80
Mean HBV DNA Reduction (log10 copies/mL)
Percentage of Patients