慢性乙型肝炎患者管理(英文版)45页PPT文档
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2
Introduction
Treatment challenges highlight need for new management approach
• Treating hepatitis B virus (HBV) infection continues to be a
challenge for physicians due to
suppression and clinical outcome
• To assess the role of early and effective viral load reduction and
the association with clinical outcomes*
• To review an on-treatment management strategy – the roadmap
concept – that may offer a valuable opportunity for enhanced treatment response
* For safety information on the products referred to, please refer to the Product Information. 4
i. Natural history studies ii. Impact of treatment
Key role of HBV DNA in On-Treatment Management
i. Timing and magnitude of HBV DNA suppression
On-Treatment Roadmap Concept Summary and Conclusions
– Does long-term suppression of HBV replication achieve the goals of
treatment in CHB?
– Can the degree of on-treatment viral suppression predict outcomes? – Does profound, early viral suppression at week 24 predict clinical
outcomes?
3
Presentation Objectives
• To explore the association between persistent viraemia and
hepatitis disease progression
• To assess the relationship between the degree of viral
5
Data Review: Associations of HBV DNA with Outcomes
i. Natural history studies
Correlation Between HBV DNA and Histologic Activity Index (HAI) in Untreated Patients
6.5
5.6
10
2.5
1.4
1.0
0
0 1 2 3 4 5 6 7 8 9 10 11 12 13
Year of follow-up
Iloeje et al 2019 7
Hepatocellular Carcinoma (HCC)
Association with baseline HBV DNA: Taiwan natural history study
1
Roadmap for Management of Patients with
Chronic Hepatitis B (CHB)
Prof. Xinxin Zhang Rui Jin Hospital
Jiao Tong University
Contents
Introduction Presentation Objectives Data Review: Associations of HBV DNA with Outcomes
evaluation of treatment response; however, a standard on-treatment management approach does not exist
• To establish a new treatment paradigm, we should ask
– Complications arising from chronic HBV (CHB) – The increasing number of available therapeutic options
• Treatment guidelines recognize the importance of monitoring and
HAI at baHale Waihona Puke Baidueline
12
10
8
6
4
r=0.78; P=0.0001
2
0
0
2
4
6
8
10
12
Baseline HBV DNA level, log10 copies/mL
• Review of 26 prospective clinical trials found a statistically significant
Cumulative incidence of cirrhosis, %
40
HBV DNA at entry, copies/mL:
>1,000,000
10,000–999,999
30
1000–9999
300–999 <300
P<0.001 (log-rank test)
20
Multivariate adjusted hazard ratio
correlation between viral load level and histological grading
Mommeja-Marin et al 2019 6
Cirrhosis: Association with Baseline HBV DNA
Taiwan natural history study
Introduction
Treatment challenges highlight need for new management approach
• Treating hepatitis B virus (HBV) infection continues to be a
challenge for physicians due to
suppression and clinical outcome
• To assess the role of early and effective viral load reduction and
the association with clinical outcomes*
• To review an on-treatment management strategy – the roadmap
concept – that may offer a valuable opportunity for enhanced treatment response
* For safety information on the products referred to, please refer to the Product Information. 4
i. Natural history studies ii. Impact of treatment
Key role of HBV DNA in On-Treatment Management
i. Timing and magnitude of HBV DNA suppression
On-Treatment Roadmap Concept Summary and Conclusions
– Does long-term suppression of HBV replication achieve the goals of
treatment in CHB?
– Can the degree of on-treatment viral suppression predict outcomes? – Does profound, early viral suppression at week 24 predict clinical
outcomes?
3
Presentation Objectives
• To explore the association between persistent viraemia and
hepatitis disease progression
• To assess the relationship between the degree of viral
5
Data Review: Associations of HBV DNA with Outcomes
i. Natural history studies
Correlation Between HBV DNA and Histologic Activity Index (HAI) in Untreated Patients
6.5
5.6
10
2.5
1.4
1.0
0
0 1 2 3 4 5 6 7 8 9 10 11 12 13
Year of follow-up
Iloeje et al 2019 7
Hepatocellular Carcinoma (HCC)
Association with baseline HBV DNA: Taiwan natural history study
1
Roadmap for Management of Patients with
Chronic Hepatitis B (CHB)
Prof. Xinxin Zhang Rui Jin Hospital
Jiao Tong University
Contents
Introduction Presentation Objectives Data Review: Associations of HBV DNA with Outcomes
evaluation of treatment response; however, a standard on-treatment management approach does not exist
• To establish a new treatment paradigm, we should ask
– Complications arising from chronic HBV (CHB) – The increasing number of available therapeutic options
• Treatment guidelines recognize the importance of monitoring and
HAI at baHale Waihona Puke Baidueline
12
10
8
6
4
r=0.78; P=0.0001
2
0
0
2
4
6
8
10
12
Baseline HBV DNA level, log10 copies/mL
• Review of 26 prospective clinical trials found a statistically significant
Cumulative incidence of cirrhosis, %
40
HBV DNA at entry, copies/mL:
>1,000,000
10,000–999,999
30
1000–9999
300–999 <300
P<0.001 (log-rank test)
20
Multivariate adjusted hazard ratio
correlation between viral load level and histological grading
Mommeja-Marin et al 2019 6
Cirrhosis: Association with Baseline HBV DNA
Taiwan natural history study