Peginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B
Identifieur interne : 00A509 ( Main/Exploration ); précédent : 00A508; suivant : 00A510Peginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B
Auteurs : George K. K. Lau [Hong Kong] ; Teerha Piratvisuth [Thaïlande] ; KANG XIAN LUO [République populaire de Chine] ; Patrick Marcellin [France] ; Satawat Thongsawat [Thaïlande] ; Graham Cooksley [Australie] ; Edward Gane [Nouvelle-Zélande] ; Michael W. Fried [États-Unis] ; WAN CHENG CHOW [Singapour] ; SEUNG WOON PAIK [Corée du Sud] ; WEN YU CHANG [Taïwan] ; Thomas Berg [Allemagne] ; Robert Flisiak [Pologne] ; Philip Mccloud ; Nigel PluckSource :
- The New England journal of medicine [ 0028-4793 ] ; 2005.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Médecine.
English descriptors
- KwdEn :
Abstract
BACKGROUND Current treatments for chronic hepatitis B are suboptimal. In the search for improved therapies, we compared the efficacy and safety ofpegylated interferon alfa plus lamivudine, pegylated interferon alfa without lamivudine, and lamivudine alone for the treatment of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. METHODS A total of 814 patients with HBeAg-positive chronic hepatitis B received either peginterferon alfa-2a (180 pg once weekly) plus oral placebo, peginterferon alfa-2a plus lamivudine (100 mg daily), or lamivudine alone. The majority of patients in the study were Asian (87 percent). Most patients were infected with hepatitis B virus (HBV) genotype B or C. Patients were treated for 48 weeks and followed for an additional 24 weeks. RESULTS After 24 weeks of follow-up, significantly more patients who received peginterferon alfa-2a monotherapy or peginterferon alfa-2a plus lamivudine than those who received lamivudine monotherapy had HBeAg seroconversion (32 percent vs. 19 percent [P<0.001] and 27 percent vs. 19 percent [P=0.02], respectively) or HBV DNA levels below 100,000 copies per milliliter (32 percent vs. 22 percent [P=0.01] and 34 percentvs. 22 percent [P=0.003], respectively). Sixteen patients receiving peginterferon alfa-2a (alone or in combination) had hepatitis B surface antigen (HBsAg) seroconversion, as compared with 0 in the group receiving lamivudine alone (P=0.001). The most common adverse events were those known to occur with therapies based on interferon alfa. Serious adverse events occurred in 4 percent, 6 percent, and 2 percent of patients receiving peginterferon alfa-2a monotherapy, combination therapy, and lamivudine monotherapy, respectively. Two patients receiving lamivudine monotherapy had irreversible liver failure after the cessation of treatment- one underwent liver transplantation, and the other died. CONCLUSIONS In patients with HBeAg-positive chronic hepatitis B, peginterferon alfa-2a offers superior efficacy over lamivudine, on the basis of HBeAg seroconversion, HBV DNA suppression, and HBsAg seroconversion.
Affiliations:
- Allemagne, Australie, Corée du Sud, France, Hong Kong, Nouvelle-Zélande, Pologne, République populaire de Chine, Singapour, Taïwan, Thaïlande, États-Unis
- Berlin, Guangdong, Région capitale de Séoul
- Berlin, Jiangmen, Séoul
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Fried</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>University of North Carolina Liver Program, University of North Carolina</s1><s2>Chapel Hill</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chapel Hill</wicri:noRegion></affiliation></author><author><name sortKey="Wan Cheng Chow" sort="Wan Cheng Chow" uniqKey="Wan Cheng Chow" last="Wan Cheng Chow">WAN CHENG CHOW</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Gastroenterology Department, Singapore General Hospital</s1><s3>SGP</s3><sZ>9 aut.</sZ></inist:fA14><country>Singapour</country><wicri:noRegion>Gastroenterology Department, Singapore General Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Seung Woon Paik" sort="Seung Woon Paik" uniqKey="Seung Woon Paik" last="Seung Woon Paik">SEUNG WOON PAIK</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine</s1><s2>Seoul</s2><s3>KOR</s3><sZ>10 aut.</sZ></inist:fA14><country>Corée du Sud</country><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Wen Yu Chang" sort="Wen Yu Chang" uniqKey="Wen Yu Chang" last="Wen Yu Chang">WEN YU CHANG</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Internal Medicine, Kaohsiung Medical University Hospital</s1><s2>Kaohsiung</s2><s3>TWN</s3><sZ>11 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>Kaohsiung</wicri:noRegion></affiliation></author><author><name sortKey="Berg, Thomas" sort="Berg, Thomas" uniqKey="Berg T" first="Thomas" last="Berg">Thomas Berg</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité, Universitätsmedizin Berlin, Campus Virchow- Klinikum</s1><s2>Berlin</s2><s3>DEU</s3><sZ>12 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Flisiak, Robert" sort="Flisiak, Robert" uniqKey="Flisiak R" first="Robert" last="Flisiak">Robert Flisiak</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Infectious Diseases, Medical University of Bialystok</s1><s2>Bialystok</s2><s3>POL</s3><sZ>13 aut.</sZ></inist:fA14><country>Pologne</country><wicri:noRegion>Bialystok</wicri:noRegion></affiliation></author><author><name sortKey="Mccloud, Philip" sort="Mccloud, Philip" uniqKey="Mccloud P" first="Philip" last="Mccloud">Philip Mccloud</name></author><author><name sortKey="Pluck, Nigel" sort="Pluck, Nigel" uniqKey="Pluck N" first="Nigel" last="Pluck">Nigel Pluck</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">05-0309411</idno><date when="2005">2005</date><idno type="stanalyst">PASCAL 05-0309411 INIST</idno><idno type="RBID">Pascal:05-0309411</idno><idno type="wicri:Area/PascalFrancis/Corpus">004878</idno><idno type="wicri:Area/PascalFrancis/Curation">001825</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">004458</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">004458</idno><idno type="wicri:doubleKey">0028-4793:2005:Lau G:peginterferon:alfa:a</idno><idno type="wicri:Area/Main/Merge">00B108</idno><idno type="wicri:Area/Main/Curation">00A509</idno><idno type="wicri:Area/Main/Exploration">00A509</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Peginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B</title><author><name sortKey="Lau, George K K" sort="Lau, George K K" uniqKey="Lau G" first="George K. K." last="Lau">George K. K. Lau</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Medicine, Queen Mary Hospital, University of Hong Kong</s1><s3>HKG</s3><sZ>1 aut.</sZ></inist:fA14><country>Hong Kong</country><wicri:noRegion>Department of Medicine, Queen Mary Hospital, University of Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Piratvisuth, Teerha" sort="Piratvisuth, Teerha" uniqKey="Piratvisuth T" first="Teerha" last="Piratvisuth">Teerha Piratvisuth</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Medicine, Songklanakarin Hospital</s1><s2>Songkla</s2><s3>THA</s3><sZ>2 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Songkla</wicri:noRegion></affiliation></author><author><name sortKey="Kang Xian Luo" sort="Kang Xian Luo" uniqKey="Kang Xian Luo" last="Kang Xian Luo">KANG XIAN LUO</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Infectious Diseases, Nangfang Hospital</s1><s2>Guangzhou</s2><s3>CHN</s3><sZ>3 aut.</sZ></inist:fA14><country>République populaire de Chine</country><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Marcellin, Patrick" sort="Marcellin, Patrick" uniqKey="Marcellin P" first="Patrick" last="Marcellin">Patrick Marcellin</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Service d'Hépatologie, INSERM Unitt 481, and Centre de Recherches Claude Bernard sur les Hépatites Virales, Hôpital Beaujon</s1><s2>Clichy</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Clichy</wicri:noRegion><wicri:noRegion>Hôpital Beaujon</wicri:noRegion><wicri:noRegion>Clichy</wicri:noRegion></affiliation></author><author><name sortKey="Thongsawat, Satawat" sort="Thongsawat, Satawat" uniqKey="Thongsawat S" first="Satawat" last="Thongsawat">Satawat Thongsawat</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Internal Medicine, Chiang Mai University</s1><s2>Chiang Mai</s2><s3>THA</s3><sZ>5 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Chiang Mai</wicri:noRegion></affiliation></author><author><name sortKey="Cooksley, Graham" sort="Cooksley, Graham" uniqKey="Cooksley G" first="Graham" last="Cooksley">Graham Cooksley</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Clinical Research Department, Royal Brisbane Hospital</s1><s2>Herston</s2><s3>AUS</s3><sZ>6 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Herston</wicri:noRegion></affiliation></author><author><name sortKey="Gane, Edward" sort="Gane, Edward" uniqKey="Gane E" first="Edward" last="Gane">Edward Gane</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Gastroenterology Department, Middlemore Hospital</s1><s2>Otahuhu</s2><s3>NZL</s3><sZ>7 aut.</sZ></inist:fA14><country>Nouvelle-Zélande</country><wicri:noRegion>Otahuhu</wicri:noRegion></affiliation></author><author><name sortKey="Fried, Michael W" sort="Fried, Michael W" uniqKey="Fried M" first="Michael W." last="Fried">Michael W. Fried</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>University of North Carolina Liver Program, University of North Carolina</s1><s2>Chapel Hill</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Chapel Hill</wicri:noRegion></affiliation></author><author><name sortKey="Wan Cheng Chow" sort="Wan Cheng Chow" uniqKey="Wan Cheng Chow" last="Wan Cheng Chow">WAN CHENG CHOW</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Gastroenterology Department, Singapore General Hospital</s1><s3>SGP</s3><sZ>9 aut.</sZ></inist:fA14><country>Singapour</country><wicri:noRegion>Gastroenterology Department, Singapore General Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Seung Woon Paik" sort="Seung Woon Paik" uniqKey="Seung Woon Paik" last="Seung Woon Paik">SEUNG WOON PAIK</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine</s1><s2>Seoul</s2><s3>KOR</s3><sZ>10 aut.</sZ></inist:fA14><country>Corée du Sud</country><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Wen Yu Chang" sort="Wen Yu Chang" uniqKey="Wen Yu Chang" last="Wen Yu Chang">WEN YU CHANG</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Internal Medicine, Kaohsiung Medical University Hospital</s1><s2>Kaohsiung</s2><s3>TWN</s3><sZ>11 aut.</sZ></inist:fA14><country>Taïwan</country><wicri:noRegion>Kaohsiung</wicri:noRegion></affiliation></author><author><name sortKey="Berg, Thomas" sort="Berg, Thomas" uniqKey="Berg T" first="Thomas" last="Berg">Thomas Berg</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité, Universitätsmedizin Berlin, Campus Virchow- Klinikum</s1><s2>Berlin</s2><s3>DEU</s3><sZ>12 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Flisiak, Robert" sort="Flisiak, Robert" uniqKey="Flisiak R" first="Robert" last="Flisiak">Robert Flisiak</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Infectious Diseases, Medical University of Bialystok</s1><s2>Bialystok</s2><s3>POL</s3><sZ>13 aut.</sZ></inist:fA14><country>Pologne</country><wicri:noRegion>Bialystok</wicri:noRegion></affiliation></author><author><name sortKey="Mccloud, Philip" sort="Mccloud, Philip" uniqKey="Mccloud P" first="Philip" last="Mccloud">Philip Mccloud</name></author><author><name sortKey="Pluck, Nigel" sort="Pluck, Nigel" uniqKey="Pluck N" first="Nigel" last="Pluck">Nigel Pluck</name></author></analytic><series><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antineoplastic agent</term><term>Antiretroviral agent</term><term>Antiviral</term><term>Immunomodulator</term><term>Lamivudine</term><term>Medicine</term><term>Peginterferon alfa-2a</term><term>Viral hepatitis B</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Peginterféron alfa-2a</term><term>Lamivudine</term><term>Hépatite virale B</term><term>Médecine</term><term>Immunomodulateur</term><term>Antiviral</term><term>Antirétroviral</term><term>Anticancéreux</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND Current treatments for chronic hepatitis B are suboptimal. In the search for improved therapies, we compared the efficacy and safety ofpegylated interferon alfa plus lamivudine, pegylated interferon alfa without lamivudine, and lamivudine alone for the treatment of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. METHODS A total of 814 patients with HBeAg-positive chronic hepatitis B received either peginterferon alfa-2a (180 pg once weekly) plus oral placebo, peginterferon alfa-2a plus lamivudine (100 mg daily), or lamivudine alone. The majority of patients in the study were Asian (87 percent). Most patients were infected with hepatitis B virus (HBV) genotype B or C. Patients were treated for 48 weeks and followed for an additional 24 weeks. RESULTS After 24 weeks of follow-up, significantly more patients who received peginterferon alfa-2a monotherapy or peginterferon alfa-2a plus lamivudine than those who received lamivudine monotherapy had HBeAg seroconversion (32 percent vs. 19 percent [P<0.001] and 27 percent vs. 19 percent [P=0.02], respectively) or HBV DNA levels below 100,000 copies per milliliter (32 percent vs. 22 percent [P=0.01] and 34 percentvs. 22 percent [P=0.003], respectively). Sixteen patients receiving peginterferon alfa-2a (alone or in combination) had hepatitis B surface antigen (HBsAg) seroconversion, as compared with 0 in the group receiving lamivudine alone (P=0.001). The most common adverse events were those known to occur with therapies based on interferon alfa. Serious adverse events occurred in 4 percent, 6 percent, and 2 percent of patients receiving peginterferon alfa-2a monotherapy, combination therapy, and lamivudine monotherapy, respectively. Two patients receiving lamivudine monotherapy had irreversible liver failure after the cessation of treatment- one underwent liver transplantation, and the other died. CONCLUSIONS In patients with HBeAg-positive chronic hepatitis B, peginterferon alfa-2a offers superior efficacy over lamivudine, on the basis of HBeAg seroconversion, HBV DNA suppression, and HBsAg seroconversion.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Corée du Sud</li><li>France</li><li>Hong Kong</li><li>Nouvelle-Zélande</li><li>Pologne</li><li>République populaire de Chine</li><li>Singapour</li><li>Taïwan</li><li>Thaïlande</li><li>États-Unis</li></country><region><li>Berlin</li><li>Guangdong</li><li>Région capitale de Séoul</li></region><settlement><li>Berlin</li><li>Jiangmen</li><li>Séoul</li></settlement></list><tree><noCountry><name sortKey="Mccloud, Philip" sort="Mccloud, Philip" uniqKey="Mccloud P" first="Philip" last="Mccloud">Philip Mccloud</name><name sortKey="Pluck, Nigel" sort="Pluck, Nigel" uniqKey="Pluck N" first="Nigel" last="Pluck">Nigel Pluck</name></noCountry><country name="Hong Kong"><noRegion><name sortKey="Lau, George K K" sort="Lau, George K K" uniqKey="Lau G" first="George K. K." last="Lau">George K. K. Lau</name></noRegion></country><country name="Thaïlande"><noRegion><name sortKey="Piratvisuth, Teerha" sort="Piratvisuth, Teerha" uniqKey="Piratvisuth T" first="Teerha" last="Piratvisuth">Teerha Piratvisuth</name></noRegion><name sortKey="Thongsawat, Satawat" sort="Thongsawat, Satawat" uniqKey="Thongsawat S" first="Satawat" last="Thongsawat">Satawat Thongsawat</name></country><country name="République populaire de Chine"><region name="Guangdong"><name sortKey="Kang Xian Luo" sort="Kang Xian Luo" uniqKey="Kang Xian Luo" last="Kang Xian Luo">KANG XIAN LUO</name></region></country><country name="France"><noRegion><name sortKey="Marcellin, Patrick" sort="Marcellin, Patrick" uniqKey="Marcellin P" first="Patrick" last="Marcellin">Patrick Marcellin</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Cooksley, Graham" sort="Cooksley, Graham" uniqKey="Cooksley G" first="Graham" last="Cooksley">Graham Cooksley</name></noRegion></country><country name="Nouvelle-Zélande"><noRegion><name sortKey="Gane, Edward" sort="Gane, Edward" uniqKey="Gane E" first="Edward" last="Gane">Edward Gane</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Fried, Michael W" sort="Fried, Michael W" uniqKey="Fried M" first="Michael W." last="Fried">Michael W. Fried</name></noRegion></country><country name="Singapour"><noRegion><name sortKey="Wan Cheng Chow" sort="Wan Cheng Chow" uniqKey="Wan Cheng Chow" last="Wan Cheng Chow">WAN CHENG CHOW</name></noRegion></country><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Seung Woon Paik" sort="Seung Woon Paik" uniqKey="Seung Woon Paik" last="Seung Woon Paik">SEUNG WOON PAIK</name></region></country><country name="Taïwan"><noRegion><name sortKey="Wen Yu Chang" sort="Wen Yu Chang" uniqKey="Wen Yu Chang" last="Wen Yu Chang">WEN YU CHANG</name></noRegion></country><country name="Allemagne"><region name="Berlin"><name sortKey="Berg, Thomas" sort="Berg, Thomas" uniqKey="Berg T" first="Thomas" last="Berg">Thomas Berg</name></region></country><country name="Pologne"><noRegion><name sortKey="Flisiak, Robert" sort="Flisiak, Robert" uniqKey="Flisiak R" first="Robert" last="Flisiak">Robert Flisiak</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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