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Article: Peginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B

TitlePeginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis B
Authors
Issue Date2005
PublisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/
Citation
New England Journal of Medicine, 2005, v. 352 n. 26, p. 2682-2695 How to Cite?
AbstractBACKGROUND: Current treatments for chronic hepatitis B are suboptimal. In the search for improved therapies, we compared the efficacy and safety of pegylated 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 microg 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 percent vs. 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.
Persistent Identifierhttp://hdl.handle.net/10722/43075
ISSN
2014 Impact Factor: 55.873
2014 SCImago Journal Rankings: 12.155
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLau, GKen_HK
dc.contributor.authorPiratvisuth, Ten_HK
dc.contributor.authorLuo, KXen_HK
dc.contributor.authorMarcellin, Pen_HK
dc.contributor.authorThongsawat, Sen_HK
dc.contributor.authorCooksley, Gen_HK
dc.contributor.authorGane, Een_HK
dc.contributor.authorFried, MWen_HK
dc.contributor.authorChow, WCen_HK
dc.contributor.authorPaik, SWen_HK
dc.contributor.authorChang, WYen_HK
dc.contributor.authorBerg, Ten_HK
dc.contributor.authorFlisiak, Ren_HK
dc.contributor.authorMcCloud, Pen_HK
dc.contributor.authorPluck, Nen_HK
dc.date.accessioned2007-03-23T04:38:17Z-
dc.date.available2007-03-23T04:38:17Z-
dc.date.issued2005en_HK
dc.identifier.citationNew England Journal of Medicine, 2005, v. 352 n. 26, p. 2682-2695en_HK
dc.identifier.issn0028-4793en_HK
dc.identifier.urihttp://hdl.handle.net/10722/43075-
dc.description.abstractBACKGROUND: Current treatments for chronic hepatitis B are suboptimal. In the search for improved therapies, we compared the efficacy and safety of pegylated 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 microg 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 percent vs. 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.en_HK
dc.format.extent176172 bytes-
dc.format.extent3155 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypetext/plain-
dc.languageengen_HK
dc.publisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/en_HK
dc.rightsNew England Journal of Medicine. Copyright © Massachusetts Medical Society.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAntiviral agents - administration & dosage - adverse effects - therapeutic useen_HK
dc.subject.meshHepatitis b, chronic - drug therapyen_HK
dc.subject.meshInterferon alfa-2a - adverse effects - therapeutic useen_HK
dc.subject.meshLamivudine - adverse effects - therapeutic useen_HK
dc.subject.meshPolyethylene glycols - adverse effects - therapeutic useen_HK
dc.titlePeginterferon Alfa-2a, lamivudine, and the combination for HBeAg-positive chronic hepatitis Ben_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0028-4793&volume=352&issue=26&spage=2682&epage=2695&date=2005&atitle=Peginterferon+Alfa-2a,+lamivudine,+and+the+combination+for+HBeAg-positive+chronic+hepatitis+Ben_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1056/NEJMoa043470-
dc.identifier.pmid15987917en_HK
dc.identifier.scopuseid_2-s2.0-21244447705-
dc.identifier.hkuros115830-
dc.identifier.isiWOS:000230133800005-

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