Rasi G, DiVirgilio D, Mutchnick M G, Colella F, Sinibaldi-Vallebona P, Pierimarchi P, Valli B, Garaci E
Istituto di Medicina Sperimentale, CNR-Roma, Italy.
Gut. 1996 Nov;39(5):679-83. doi: 10.1136/gut.39.5.679.
Monotherapy for chronic hepatitis C using interferon (IFN) results in a very small proportion of patients exhibiting a sustained response. Clinical trials assessing the benefit of combination drug therapy may provide evidence of improved treatment response over that seen with single drug treatment.
To assess the response in patients with chronic hepatitis C to one year of combination treatment: thymosin alpha 1 (T alpha 1), 1 mg twice weekly, and lymphoblastoid (L)-IFN, 3 MU thrice weekly.
Fifteen patients with serum HCV RNA positive chronic hepatitis C were studied. Eleven patients were treatment naive and four had failed previous standard IFN therapy. Thirteen patients were HCV RNA serotype 1b. All patients were given combination T alpha 1 and L-IFN therapy for one year with a six month follow up period.
Six months after initiation of treatment seven patients (47%) were sera HCV RNA negative and at completion of the one year treatment 11 (73%), including two who had failed previous standard IFN treatment, had negative serum HCV RNA. Six months after treatment, six patients (40%), including five with HCV type 1b, showed a sustained response characterized by a negative serum HCV RNA.
The results of this open label trial suggest that there may be a potential benefit to combining an immune modulator (T alpha 1) with an antiviral (IFN) in the treatment of chronic hepatitis C. Verification of the observations in this study require completion of a randomised controlled study.
使用干扰素(IFN)对慢性丙型肝炎进行单一疗法时,只有极小比例的患者会出现持续应答。评估联合药物疗法益处的临床试验可能会提供证据,证明其治疗应答优于单一药物治疗。
评估慢性丙型肝炎患者接受一年联合治疗的应答情况:胸腺肽α1(Tα1),每周两次,每次1毫克,以及淋巴母细胞样(L)-IFN,每周三次,每次3百万单位。
对15例血清HCV RNA阳性的慢性丙型肝炎患者进行了研究。11例患者此前未接受过治疗,4例曾接受标准IFN治疗但失败。13例患者的HCV RNA血清型为1b。所有患者均接受Tα1和L-IFN联合治疗一年,并随访6个月。
治疗开始6个月后,7例患者(47%)血清HCV RNA呈阴性,一年治疗结束时,11例(73%)血清HCV RNA呈阴性,其中包括2例曾接受标准IFN治疗失败的患者。治疗6个月后,6例患者(40%),包括5例HCV 1b型患者,表现出以血清HCV RNA阴性为特征的持续应答。
这项开放标签试验的结果表明,在慢性丙型肝炎治疗中,将免疫调节剂(Tα1)与抗病毒药物(IFN)联合使用可能有益。本研究结果的验证需要完成一项随机对照研究。