Lim S G, Marcellin P, Tassopoulos N, Hadziyannis S, Chang T T, Tong M, Sievert W, Hu P, Arterburn S, Brosgart C L
National University Hospital, Singapore.
Aliment Pharmacol Ther. 2007 Nov 15;26(10):1419-28. doi: 10.1111/j.1365-2036.2007.03506.x.
Two-thirds of the 350 million people infected with chronic hepatitis B virus live in the Asia-Pacific region. AIM To compare the effects of adefovir dipivoxil therapy between Asian and Caucasian patients with chronic hepatitis B.
The safety and efficacy of 10 mg of adefovir dipivoxil was compared to placebo in 501 Asian (n = 259) or Caucasian (n = 242) HBeAg+ and HBeAg- chronic hepatitis B virus patients treated for 48 weeks in two randomized, double-blind, placebo-controlled studies.
At week 48, histological improvement was observed in 60% and 56% of Caucasian and Asian patients, respectively. Change in serum hepatitis B virus DNA from baseline to week 48 for the adefovir dipivoxil-treated patients was -3.89 and -3.70 log(10) copies/mL in Caucasian and Asian patients, respectively, while 34 per cent of Caucasian patients and 39 per cent of Asian patients had undetectable serum hepatitis B virus DNA (<400 copies/mL) at week 48. The percentage of patients achieving alanine aminotransferase (ALT) normalization at week 48 was similar in both groups (Caucasian 64 per cent, Asian 63 per cent). No patients developed resistance through week 48. No differences in adverse events or grade 3 or 4 laboratory abnormalities were observed between groups.
There were no significant differences in treatment response between Asians and Caucasians. Adefovir dipivoxil was well tolerated and no resistance developed up to week 48 in both racial groups.
3.5亿慢性乙型肝炎病毒感染者中有三分之二生活在亚太地区。目的:比较亚洲和高加索慢性乙型肝炎患者接受阿德福韦酯治疗的效果。
在两项随机、双盲、安慰剂对照研究中,将10mg阿德福韦酯的安全性和有效性与安慰剂进行比较,共有501例亚洲(n = 259)或高加索(n = 242)HBeAg阳性和HBeAg阴性慢性乙型肝炎病毒患者接受了48周的治疗。
在第48周时,高加索和亚洲患者分别有60%和56%出现组织学改善。接受阿德福韦酯治疗的患者从基线到第48周血清乙型肝炎病毒DNA的变化,在高加索患者和亚洲患者中分别为-3.89和-3.70 log(10)拷贝/毫升,而在第48周时,34%的高加索患者和39%的亚洲患者血清乙型肝炎病毒DNA检测不到(<400拷贝/毫升)。两组在第48周时实现丙氨酸转氨酶(ALT)正常化的患者百分比相似(高加索64%,亚洲63%)。到第48周没有患者产生耐药性。两组之间在不良事件或3级或4级实验室异常方面没有观察到差异。
亚洲人和高加索人在治疗反应上没有显著差异。阿德福韦酯耐受性良好,两个种族组在第48周时均未产生耐药性。