丙肝治疗的研究进展北京武警三院肝病中心-培训课件.pptVIP

R7227+R7128与R7227+派罗欣+RBV 在G1型初治患者中的病毒动力学比较 R7227 900mg BID R7128 1000mg BID 2 0 4 6 8 10 12 14 1 2 3 4 5 6 7 Log10 HCV RNA (IU/mL)中位值 天 检测限 R7227/R7128 R7227/派罗欣/RBV Morcos, et al. AASLD 2009. poster #1594 INFORM-1研究结论 该联合治疗方案耐受性良好，未出现治疗相关严重不良事件、剂量调整或停药的报告 对于初治和复治患者， R7227+R7128与R7227+SOC方案均有理想的病毒学应答 未发现治疗相关的耐药突变株 R7128/R7227联合用药可以持续抑制病毒水平(73/74例) Gane et al, AASLD 2009, oral (193) 小分子化合物的特点 优势：提高SVR，缩短疗程 局限性： 1.尚不能完全脱离干扰素 2.目前欧美仅用于基因1型 3.耐药问题，有些研究发现耐药突变可长期存在。 展望：发展敏感的检测方法，发展高耐药屏障的药物。 谢 谢 派罗欣HCV Global Slide Kit + + Slide *. A number of baseline factors have a strong impact on SVR Swain, et al. investigated the complex relationships between body weight, other baseline factors, and treatment outcomes in patients treated with PEGASYS? plus COPEGUS? in two phase III studies.1,2 The SVR rate was significantly higher in patients in patients weighing ≤75.5 kg compared with 75.5 kg (67% vs 52%; p=0.00001). However, the SVR rate was also significantly higher in patients with genotype non-1 (p0.001 vs genotype 1), HCV RNA ≤1 million copies/mL (p0.001 vs 1 million copies/mL), females (p=0.034 vs males), age ≤40 years (p0.001 vs 40 years), Asian race (p=0.026 vs White), ALT 3 (p=0.039 vs ALT ≤3) and no cirrhosis (p=0.003 vs cirrhosis).3 1. Fried M, et al. N Engl J Med 2002; 347: 975 2. Hadziyannis S, et al. Ann Intern Med 2004; 140: 346 3. Swain, M et al. 41st EASL 2006; Abstract 611 * tpcr09_t Slide 14. Treatment duration has a greater impact than induction dosing on rate of SVR Although the rate of SVR was higher for the pooled induction arms versus the pooled non-induction arms the difference was not statistically significant (p=0.92; OR 0.98 [95% CI 0.63-1.51]). Extending the duration of treatment to 72 weeks resulted in a significant increase in SVR. Sixteen percent of patients treated for 72 weeks (Groups A and C pooled) achieved SVR compared with 8% treated with standard of care (Groups B and D pooled) (p=0.0006; odds rati