Yoshioka K, Yano M, Kusakabe A, Hirofuji H, Fuji A, Kuriki J, Arao M, Murase K, Kidokoro R, Kakumu S
Third Department of Internal Medicine, Nagoya University School of Medicine, Nagoya First Red Cross Hospital, Japan.
Am J Gastroenterol. 1999 Jan;94(1):164-8. doi: 10.1111/j.1572-0241.1999.00789.x.
We conducted a randomized controlled trial to compare the efficacy of two different dosages of lymphoblastoid interferon alpha (IFN) for the treatment of chronic hepatitis C.
Eighty-four patients with chronic hepatitis C were enrolled and randomly assigned into the two groups; group A was treated with 6 million units (MU) and group B with 9 MU daily for the first 2 wk, and then thrice weekly for an additional 14 or 22 wk.
Eighty patients were evaluated (39 patients in group A and 41 in group B); 14 patients in group A (35.9%) and 15 in group B (36.6%) obtained sustained response. The percentages of patients who became negative for HCV RNA at the end of the second wk differed slightly between the groups, without statistical significance (56.4% and 68.3%). When assessed in detail, patients with genotype 1 and < 1 Meq/ml of viral load became negative for HCV RNA significantly more frequently in group B (eight of eight) than in group A (three of seven) (p < 0.05) at the end of the second week, whereas the sustained response rate was similar between the groups (five of eight and four of seven). Predictors of sustained response by multivariate analysis were low viral load (< 1.0 Meq/ml) and negativity of HCV RNA at the end of the second wk of IFN.
The results indicated that there was no difference in sustained response rate between the 6-MU and 9-MU doses. The earlier disappearance of HCV RNA, at the end of the second wk or at least by the end of the fourth week, is an essential condition for sustained response.
我们进行了一项随机对照试验,以比较两种不同剂量的淋巴母细胞样α干扰素(IFN)治疗慢性丙型肝炎的疗效。
84例慢性丙型肝炎患者入组并随机分为两组;A组在前2周每天接受600万单位(MU)治疗,B组每天接受900万单位治疗,之后每周3次,持续14或22周。
80例患者接受评估(A组39例,B组41例);A组14例(35.9%)和B组15例(36.6%)获得持续应答。两组在第2周结束时HCV RNA转阴的患者百分比略有差异,但无统计学意义(56.4%和68.3%)。详细评估时,在第2周结束时,病毒载量<1 Meq/ml的1型基因型患者中,B组(8例中的8例)HCV RNA转阴的频率显著高于A组(7例中的3例)(p<0.05),而两组的持续应答率相似(8例中的5例和7例中的4例)。多因素分析显示,持续应答的预测因素为低病毒载量(<1.0 Meq/ml)和IFN治疗第2周结束时HCV RNA转阴。
结果表明,6 MU和9 MU剂量的持续应答率无差异。HCV RNA在第2周结束时或至少在第4周结束时较早消失是持续应答的必要条件。