Timing of lamivudine administration according to Child class in patients with decompensated cirrhosis

Bae, Si Hyun; Yoon, Seung Kew; Choi, Jong Young; Jang, Jeong Won; Cho, Se Hyun; Yang, Jin Mo; Han, Nam Ik; Ahn, Byung Min; Chung, Kyu Won; Sun, Hee Sik

doi:10.1111/j.1440-1746.2005.03886.x

Cited by 19 publications

(21 citation statements)

References 21 publications

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“…A small study showed that patients of Child class B needed shorter time to achieve a 2-point reduction in CTP score (5.9 vs. 14 months, p <0.001) and to gain a 0.5 g/dl increment in albumin (5.8 vs. 14 months) than patients of Child class C [43]. These results suggest that patients with decompensated cirrhosis should receive antiviral therapy as early as possible to allow a better chance of functional recovery.…”

Section: Lamivudinementioning

confidence: 96%

Hepatitis B virus-related decompensated liver cirrhosis: Benefits of antiviral therapy

Peng

Chien

Liaw

2012

Journal of Hepatology

193

133

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Following development of liver cirrhosis in patients with chronic hepatitis B, liver disease may continue to progress and decompensation or hepatocellular carcinoma (HCC) may occur, especially in those with active viral replication. Decompensation may manifest with jaundice, ascites, variceal bleeding or hepatic encephalopathy. Earlier studies have shown that the prognosis of decompensated cirrhosis is usually poor with a 5-year survival rate at 14-35% under conventional standard of care. The approval of oral antiviral agents has greatly improved the prognosis, as demonstrated in several cohort studies and randomized clinical trials involving therapy with lamivudine, adefovir dipivoxil, entecavir, telbivudine, or tenofovir disoproxil fumarate. Oral antiviral agents are effective in restoring liver function and improving survival in patients with decompensated cirrhosis especially if therapy is initiated early enough. These agents are generally well tolerated without significant side effects. However, their preventive effect in HCC development has yet to be convincingly demonstrated. Given their known resistance profiles, entecavir and tenofovir should be considered as the first-line therapy for patients with HBV-related decompensated cirrhosis.

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Section: Lamivudinementioning

confidence: 96%

Hepatitis B virus-related decompensated liver cirrhosis: Benefits of antiviral therapy

Peng

Chien

Liaw

2012

Journal of Hepatology

193

133

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“…54 This study was conducted in patients with e antigen-negative disease in which immuneinduced HBeAg seroconversion is not an option; therefore, the benefit of therapy is from the direct antiviral effect of the drug. Indeed, a decrease in viral load through antiviral therapy has been associated with histologic improvement, 26,27,[55][56][57][58][59][60][61] increased survival of patients with decompensated liver disease from hepatitis B, [62][63][64][65][66][67][68][69][70] and improved clinical outcome in patients with HBV reactivation following chemotherapy. 50,52,[71][72][73][74][75][76][77][78][79][80][81] Our analyses are conservative in the following aspects.…”

mentioning

confidence: 99%

Evaluation of the Cost-Effectiveness of Entecavir Versus Lamivudine in Hepatitis BeAg-Positive Chronic Hepatitis B Patients

Yuan¹,

Iloeje²,

Hay³

et al. 2008

JMCP

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BACKGROUND: As new treatment options for chronic hepatitis B virus (HBV) become available, evaluations of cost-effectiveness become important. Entecavir is a deoxyguanine nucleoside analogue approved by the U.S. Food and Drug Administration in March 2005 for HBV infection in adults with evidence of active viral replication and either evidence of persistent elevations in serum aminotransferases (alanine aminotransferase or aspartate aminotransferase) or histologically active disease. Entecavir has demonstrated greater suppression of viral replication compared with lamivudine, but also has a relatively higher drug acquisition cost in the United States.

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“…Di Marcov first reported the clinical effect of LAM treatment with 59 cases of HBV-related cirrhosis (45 child-Pugh with A and 4 with B), showing that a sustained suppression of HBV DNA significantly improved the prognosis of patients with liver cirrhosis (Di Marco et al, 2005). Bae reported that 58.2% of patients show complete antiviral responses using LAM in decompensated HBV-related cirrhosis, which can improve the clinical prognosis (Bae et al, 2005). However, the failure of antiviral treatment or drug resistance are dangerous factors for liver disease progression and increase the incidence of liver cancer (Yeh et al, 2011;Zoulim, 2011).…”

Section: Et Al 2269mentioning

confidence: 99%

“…To date, the reasons and mechanisms of the different clinical outcomes after HBV infection are still unknown. Substantial clinical evidence shows that the differences in clinical outcomes after HBV infection might be related to HBV DNA level, antiviral treatment response, and immune activation (Ohishi and Chayama, 2012;Di Marco et al, 2005;Bae et al, 2005). All guidelines for the prevention and treatment of chronic hepatitis B both in China and in other countries clearly state that the main aim of treatment for chronic hepatitis B is to bring down the incidence rate and death rate of liver cirrhosis and liver cancer, to prolong life and to improve living conditions (Tujios and Lee, 2012; European Association for the Study of the Liver, 2012).…”

Section: Et Al 2269mentioning

confidence: 99%

Monotherapy versus combinations of nucleos(t)ide in treatment-naive hepatitis B decompensated cirrhotic patients: A nested case-control study

Li#¹

2013

Afr. J. Pharm. Pharmacol.

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The data are limited on the long-term clincial outcome of monotherapy versus combinations of nucleos(t)ide analog (NUCs) for hepatitis B related decompensated cirrhotic patients. This study was to evaluate the efficacy in treatment-naive patients using NUCs monotherapy or combinations. Three hundred and six patients with decompensated hepatitis B cirrhosis were selected from cirrhosis cohort and divided into treatment-naive (n = 260) and control groups (n = 46). Antiviral therapies included monotherapy of lamivudine (LAM, n = 39), adefovir (ADV, n = 73), telbivudine (LDT, n = 36), entecavir (ETV, n = 48), and combinations of LAM+ADV (n = 39) or LDT+ADV (n = 25). Of these patients, 193 in antiviral therapy and 39 in control group were included for analysis over two years. The cumulative drug-resistance rate at two year was higher in the LAM (37.9%), ADV (21.2%), LDT (23.3%) than in the ETV monotherapy (2.6%), and with combinations of LAM+ADV (8.7%) or LDT+ADV (6.3%), respectively, P < 0.001. Serum hepatitis B virus (HBV) DNA undetectability in the ETV and the LDT+ADV group was higher than in the LAM, ADV and LAM+ADV group at over two years (P < 0.05). The child-pugh score (CPs) in the antiviral therapy group was decreased at two years (P < 0.05). In the control group and drug-resistant patients, however, CPs was increased. The two years cumulative incidence of liver failure in the antiviral therapy group was significantly less than the control group (OR 24.9, 95%; CI 6.5 to 94.7, P = 0.001). The total cumulative survival rate in the antiviral therapy group was higher than in control group (OR 4.2, 95%; CI 1.4 to 12.9, P = 0.017). The combinations of NUCs therapy and ETV momotherapy are optimum management for hepatitis B related decompensated cirrhotic patients.

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Timing of lamivudine administration according to Child class in patients with decompensated cirrhosis

Abstract: Long-term administration of LAM for patients with decompensated cirrhosis is effective. Earlier LAM administration in Child class B patients led to improved clinical outcomes.

Cited by 19 publications

References 21 publications

Hepatitis B virus-related decompensated liver cirrhosis: Benefits of antiviral therapy

Hepatitis B virus-related decompensated liver cirrhosis: Benefits of antiviral therapy

Evaluation of the Cost-Effectiveness of Entecavir Versus Lamivudine in Hepatitis BeAg-Positive Chronic Hepatitis B Patients

Monotherapy versus combinations of nucleos(t)ide in treatment-naive hepatitis B decompensated cirrhotic patients: A nested case-control study

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