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Conference Paper: Sequential therapy using lamivudine in entecavir-treated patients with undetectable HBV DNA–results at 48 weeks

TitleSequential therapy using lamivudine in entecavir-treated patients with undetectable HBV DNA–results at 48 weeks
Authors
Issue Date2009
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
The American Assoication for the Study of Liver Diseases 60th Annual Meeting and Postgraduate Course - The Liver Meeting, Boston, MA, 30 October - 3 November 2009. In Hepatology, 2009, v. 50 n. 4 Suppl, p. 510A Abstract no.433 How to Cite?
AbstractBackground: The aim of this study was to determine the efficacyof entecavir-lamivudine sequential therapy in patients withundetectable viral load and normal ALT after initial entecavirtreatment. If effective, this may result in reducing the cost of ther-apy. Methods: This is a 2-year prospective trial of 50 patientstreated on entecavir 0.5 mg daily for over 6 months, and hadachieved normal ALT and undetectable HBV DNA (<12 IU/mL).Patients were randomly assigned to receive continued entecavirmonotherapy, or switched to lamivudine monotherapy, at aratio of 1:1. Liver biochemistry and HBV DNA were determinedat weeks 0, 4, 12, 24, 48, 72, and 96. Patients in the lamivu-dine arm with evidence of HBV DNA rebound, as defined byan increase to >20 IU/mL on 3 consecutive measurements,were switched back to entecavir. Mutational analysis using line-probe assay would be performed at weeks 0, 24, 48, and 96.Results: Of the 50 patients, 48 patients had follow-up to 48weeks. There were no significant differences at the time of treat-ment assignment between the entecavir-entecavir and the ente-cavir-lamivudine group with respect to age, gender, HBeAgstatus, and duration of prior entecavir treatment. There was noelevation of ALT observed in any patients during the 48 weekperiod. At 24 weeks, 22/25 (88%) patients in the lamivudinearm continued to have undetectable HBV DNA, compared to25/25 (100%) patients in the entecavir arm (p=NS). Threepatients (12%) in the lamivudine arm had HBV DNA>20IU/mL, 2 at week 12 (43 IU/mL and 93 IU/mL) and 1 at week24 (86 IU/mL). None of these patients developed lamivudineresistant mutations, and were switched back to entecavir. Nofurther virological rebound was seen after 24 weeks. In patientswith follow-up to 48 weeks, all patients remaining on lamivu-dine, and those in the entecavir arm had undetectable HBVDNA. There was no difference in cumulative HBV DNArebound between the 2 groups at 48 weeks (p=NS). Conclu-sion: Preliminary results suggest that sequential therapy usingentecavir followed by lamivudine was effective in suppressingHBV DNA after initial optimal viral suppression with entecavir.Further follow-up will determine the long-term efficacy andresistance development of entecavir-lamivudine sequential ther-apy.
Persistent Identifierhttp://hdl.handle.net/10722/224431
ISSN
2015 Impact Factor: 11.711
2015 SCImago Journal Rankings: 4.752

 

DC FieldValueLanguage
dc.contributor.authorFung, JYY-
dc.contributor.authorLai, CL-
dc.contributor.authorYuen, JCH-
dc.contributor.authorCheng, CTK-
dc.contributor.authorWu, CH-
dc.contributor.authorYuen, RMF-
dc.date.accessioned2016-04-05T04:16:23Z-
dc.date.available2016-04-05T04:16:23Z-
dc.date.issued2009-
dc.identifier.citationThe American Assoication for the Study of Liver Diseases 60th Annual Meeting and Postgraduate Course - The Liver Meeting, Boston, MA, 30 October - 3 November 2009. In Hepatology, 2009, v. 50 n. 4 Suppl, p. 510A Abstract no.433-
dc.identifier.issn0270-9139-
dc.identifier.urihttp://hdl.handle.net/10722/224431-
dc.description.abstractBackground: The aim of this study was to determine the efficacyof entecavir-lamivudine sequential therapy in patients withundetectable viral load and normal ALT after initial entecavirtreatment. If effective, this may result in reducing the cost of ther-apy. Methods: This is a 2-year prospective trial of 50 patientstreated on entecavir 0.5 mg daily for over 6 months, and hadachieved normal ALT and undetectable HBV DNA (<12 IU/mL).Patients were randomly assigned to receive continued entecavirmonotherapy, or switched to lamivudine monotherapy, at aratio of 1:1. Liver biochemistry and HBV DNA were determinedat weeks 0, 4, 12, 24, 48, 72, and 96. Patients in the lamivu-dine arm with evidence of HBV DNA rebound, as defined byan increase to >20 IU/mL on 3 consecutive measurements,were switched back to entecavir. Mutational analysis using line-probe assay would be performed at weeks 0, 24, 48, and 96.Results: Of the 50 patients, 48 patients had follow-up to 48weeks. There were no significant differences at the time of treat-ment assignment between the entecavir-entecavir and the ente-cavir-lamivudine group with respect to age, gender, HBeAgstatus, and duration of prior entecavir treatment. There was noelevation of ALT observed in any patients during the 48 weekperiod. At 24 weeks, 22/25 (88%) patients in the lamivudinearm continued to have undetectable HBV DNA, compared to25/25 (100%) patients in the entecavir arm (p=NS). Threepatients (12%) in the lamivudine arm had HBV DNA>20IU/mL, 2 at week 12 (43 IU/mL and 93 IU/mL) and 1 at week24 (86 IU/mL). None of these patients developed lamivudineresistant mutations, and were switched back to entecavir. Nofurther virological rebound was seen after 24 weeks. In patientswith follow-up to 48 weeks, all patients remaining on lamivu-dine, and those in the entecavir arm had undetectable HBVDNA. There was no difference in cumulative HBV DNArebound between the 2 groups at 48 weeks (p=NS). Conclu-sion: Preliminary results suggest that sequential therapy usingentecavir followed by lamivudine was effective in suppressingHBV DNA after initial optimal viral suppression with entecavir.Further follow-up will determine the long-term efficacy andresistance development of entecavir-lamivudine sequential ther-apy.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/-
dc.relation.ispartofHepatology-
dc.rightsHepatology. Copyright © John Wiley & Sons, Inc.-
dc.rightsSpecial Statement for Preprint only Before publication: 'This is a preprint of an article accepted for publication in [The Journal of Pathology] Copyright © ([year]) ([Pathological Society of Great Britain and Ireland])'. After publication: the preprint notice should be amended to follows: 'This is a preprint of an article published in [include the complete citation information for the final version of the Contribution as published in the print edition of the Journal]' For Cochrane Library/ Cochrane Database of Systematic Reviews, add statement & acknowledgement : ‘This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 20XX, Issue X. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Please include reference to the Review and hyperlink to the original version using the following format e.g. Authors. Title of Review. Cochrane Database of Systematic Reviews 20XX, Issue #. Art. No.: CD00XXXX. DOI: 10.1002/14651858.CD00XXXX (insert persistent link to the article by using the URL: http://dx.doi.org/10.1002/14651858.CD00XXXX) (This statement should refer to the most recent issue of the Cochrane Database of Systematic Reviews in which the Review published.)-
dc.titleSequential therapy using lamivudine in entecavir-treated patients with undetectable HBV DNA–results at 48 weeks-
dc.typeConference_Paper-
dc.identifier.emailFung, JYY: jfung@sicklehut.com-
dc.identifier.emailLai, CL: hrmelcl@hku.hk-
dc.identifier.emailYuen, JCH: jchyuen@HKUCC.hku.hk-
dc.identifier.emailCheng, CTK: ctkcheng@HKUCC.hku.hk-
dc.identifier.emailWu, CH: rchwu@HKUCC.hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hkucc.hku.hk-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityYuen, RMF=rp00479-
dc.identifier.doi10.1002/hep.23302-
dc.identifier.hkuros181235-
dc.identifier.hkuros174703-
dc.identifier.volume50-
dc.identifier.issue4 Suppl-
dc.identifier.spage510A Abstract no.433-
dc.identifier.epage510A Abstract no.433-
dc.publisher.placeUnited States-

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