A randomised controlled trial of interferon alfa 2A for the treatment of chronic hepatitis B virus infection: Factor, that influence response

Mg, Brook; McDonald, J A; Karayiannis, Peter; Caruso, L; Forster, G E; Harris, J. R. W.; Hc, Thomas

doi:10.1016/0168-8278(89)90418-2

Cited by 3 publications

(6 citation statements)

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“…30 This finding was similar to that of an early, randomized, dose-finding trial that identified high dose ð10 MU/m 2 per doseÞ IFN-a given subcutaneously 3 times weekly for 6 months achieved a superior therapeutic response ðP < .05Þ. 32 Furthermore, a 6-month duration of therapy was previously associated with an improved therapeutic response to IFN-a when compared to a 3-week duration of therapy. 33 In a follow-up metaanalysis, which captured an additional 9 years of data and included 24 randomized, controlled trials of 1299 HBeAg-positive patients, IFN-a therapy for treatment of CHB significantly improved rates of persistent ALT normalization ðþ26.2% ½95% CI: 18.3%-34%Þ; HBeAg ðþ24.3% ½95% CI: 8.3%-30.4%Þ and HBsAg ðþ5.6% ½95% CI: 3.5%-7.6%Þ clearance; and sustained loss of HBV DNA ðþ23.4% ½95% CI: 17.9%-28.8%Þ.…”

Section: Pharmacologic Agents For the Treatment Of Chronic Hepatitis Bsupporting

confidence: 72%

“…Additional predictors of a favorable response to IFN-a treatment include low baseline HBV DNA levels, high baseline ALT levels, HBV infection as an adult, and non-Asian ethnicity. 32,34,35 In patients with HBeAgnegative CHB, studies have suggested that a longer treatment duration ð24 vs. 6 monthsÞ of IFN-a treatment may be required for a sustained response. 36,37 Efficacy-pegylated-interferon.…”

Section: Pharmacologic Agents For the Treatment Of Chronic Hepatitis Bmentioning

confidence: 99%

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Chronic Hepatitis B Infection: Principles of Therapy

Scarsi

Darin

2009

Journal of Pharmacy Practice

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Chronic hepatitis B is a global health concern in many resource-limited settings due to perinatal or pediatric hepatitis B virus transmission. In the United States, pediatric infection has been virtually eliminated due to maternal screening during pregnancy and the availability of an effective vaccine. However, young adults remain an at-risk group for hepatitis B virus infection due to sexual transmission and injection drug use. The frequency of progression from acute hepatitis B virus infection to chronic hepatitis B infection depends on multiple factors, including host immune function and age at time of hepatitis B virus infection. Fortunately, there are 7 currently approved therapies for chronic hepatitis B infection, and several emerging therapies that show promise. Despite the availability of these agents, many clinical questions still surround chronic hepatitis B therapy including when to start therapy, which agent is ideal for first and second line therapy, the appropriate duration of therapy, and the role of combination antiviral therapy. This review focuses on agents available for chronic hepatitis B management, including pharmacology, safety and efficacy data, monitoring parameters, and the role for each in chronic hepatitis B therapy in adult patients.

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Section: Pharmacologic Agents For the Treatment Of Chronic Hepatitis Bsupporting

confidence: 72%

Section: Pharmacologic Agents For the Treatment Of Chronic Hepatitis Bmentioning

confidence: 99%

Chronic Hepatitis B Infection: Principles of Therapy

Scarsi

Darin

2009

Journal of Pharmacy Practice

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“… 15 A large proportion of non‐responders had detectable levels of neutralizing antibodies to IFN‐α. 16 …”

Section: Interferon Therapy In Adults With Chronic Hepatitismentioning

confidence: 99%

Interferon monotherapy in chronic hepatitis B

Guan

2000

J of Gastro and Hepatol

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Interferon-alpha (IFN-alpha) has been the only approved agent for the treatment of chronic hepatitis B in most countries, but this is rapidly changing. It is expensive, associated with frequent and unpleasant side effects, has limited efficacy and is ineffective in subjects with no/mild liver necro-inflammation. Loss of HBsAg and viral replication markers occur 6% and 20%, more often in IFN-treated subjects than controls. The most important factors that will predict favourable response to IFN-alpha therapy are elevated ALT and low serum HBV DNA levels. Chinese patients and children with active liver have similar response rates as Caucasian adults with equivalent ALT levels. Patients with HBeAg negative disease fare less well. Long-term follow up has shown that most IFN responders maintained their response although very few people have complete eradication of HBV.

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“…The study by Perillo demonstrates that 5 MU daily is more effective than 1 MU daily [22]. Although the number of patients in the study by Brook using 2.5-10 MU/m 2 thrice weekly during 6 months, is rather small, this study also indicates that the results are dosedependent [23]. The Dusheiko study, however, demonstrates that doses of 18-50 MU do not result in higher response rates than regimens of 3-17 MU (10 MU/m 2) thrice weekly or 5 MU daily as used by other authors [21].…”

Section: Short-term Resultsmentioning

confidence: 68%

“…In the control group only 1 of the 9 patients improved from chronic active to chronic persistent hepatitis. Brook [23] found that in the 6 responders who had a second liver biopsy after 12 months posttreatment follow-up histology had improved, showing only chronic persistent hepatitis [23]. In the study by Perillo the liver biopsy specimens taken before randomization and 6 months after the completion of treatment indicated a regression of periportal necrosis in treated patients (p = 0.03 versus controls) and a trend towards reduced portal inflammation (p = 0.09), but no change in tobular inflammation or fibrosis [22].…”

Section: Long-term Resultsmentioning

confidence: 98%

Current status of interferon alpha in the treatment of chronic hepatitis B

Braken

Koopmans

Munster

et al. 1992

Pharmaceutisch Weekblad Scientific Edition

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Interferon alpha is the only available therapy for patients with chronic hepatitis B. With interferon alpha 3-15 MU thrice weekly or 5 MU daily during 3-6 months one-third of the patients achieve seroconversion of HBeAg and HBV-DNA together with normalization of aminotransferases and slight improvement of histology. Loss of HBsAg is reported in a minority of responders during treatment, but increases during follow-up. Patients with baseline alanine aminotransferase of at least twice the upper limit of normal and low HBV-DNA concentration achieve the best response rates. HIV-positive patients with low CD4 counts and Asians are poor responders. As side-effects influenza-like symptoms are experienced by almost all patients. Mild leukopenia, thrombocytopenia and decreased hairgrowth are frequently reported. Severe depression, depersonalization and psychosis are reported in a small number of patients but tend to be poorly recognized in some studies. The decision whether dose reduction is indicated seems strongly related to the opinion of the investigator. Although long-term effects on the occurrence of cirrhosis and the development of hepatocellular carcinoma are not available yet, the achieved results are promising.

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A randomised controlled trial of interferon alfa 2A for the treatment of chronic hepatitis B virus infection: Factor, that influence response

Cited by 3 publications

References 0 publications

Chronic Hepatitis B Infection: Principles of Therapy

Chronic Hepatitis B Infection: Principles of Therapy

Interferon monotherapy in chronic hepatitis B

Current status of interferon alpha in the treatment of chronic hepatitis B

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