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慢性乙型肝炎有限疗程治疗:新药类的相似与不同关注点。

Chronic Hepatitis B Finite Treatment: Similar and Different Concerns With New Drug Classes.

机构信息

Department of Medicine, Northwestern University, Chicago, Illinois, USA.

Department of Medicine, School of Clinical Medicine & State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China.

出版信息

Clin Infect Dis. 2024 Apr 10;78(4):983-990. doi: 10.1093/cid/ciad506.

Abstract

Chronic hepatitis B, a major cause of liver disease and cancer, affects >250 million people worldwide. Currently there is no cure, only suppressive therapies. Efforts to develop finite curative hepatitis B virus (HBV) therapies are underway, consisting of combinations of multiple novel agents with or without nucleos(t)ide reverse-transcriptase inhibitors. The HBV Forum convened a webinar in July 2021, along with subsequent working group discussions to address how and when to stop finite therapy for demonstration of sustained off-treatment efficacy and safety responses. Participants included leading experts in academia, clinical practice, pharmaceutical companies, patient representatives, and regulatory agencies. This Viewpoints article outlines areas of consensus within our multistakeholder group for stopping finite therapies in chronic hepatitis B investigational studies, including trial design, patient selection, outcomes, biomarkers, predefined stopping criteria, predefined retreatment criteria, duration of investigational therapies, and follow-up after stopping therapy. Future research of unmet needs are discussed.

摘要

慢性乙型肝炎是全球 2.5 亿多人罹患肝脏疾病和癌症的主要原因。目前尚无治愈方法,只有抑制疗法。正在努力开发有限的乙型肝炎病毒 (HBV) 治疗方法,包括多种新型药物联合或不联合核苷酸逆转录酶抑制剂。HBV 论坛于 2021 年 7 月举办了一次网络研讨会,并随后进行了工作组讨论,以确定如何以及何时停止有限的治疗,以证明持续的停药后疗效和安全性反应。参与者包括学术界、临床实践、制药公司、患者代表和监管机构的领先专家。本文概述了我们的多利益相关者团体在慢性乙型肝炎研究中停止有限治疗的共识领域,包括试验设计、患者选择、结局、生物标志物、预设停药标准、预设重新治疗标准、研究治疗的持续时间以及停药后的随访。讨论了未来对未满足需求的研究。

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