A trial of seq pegint and telbivudine or viceversa for 48 weeks in HBeAg-negative

[4est]

A randomized controlled trial of sequential peginterferon-alpha and
telbivudine or vice versa for 48 weeks in HBeAg-negative chronic
hepatitis B.


Source

Hepatology Unit, Tor Vergata University, Rome, Italy.
paola.***@****.

Abstract

Background Short-term treatment for HBeAg-negative chronic hepatitis B
remains unsatisfactory. Aim of our study was to compare efficacy and
safety of two sequential regimens of peginterferon ? (PEG-IFN) and
telbivudine (LdT).Methods Adult patients with biopsy-proven
HBeAg-negative chronic hepatitis B, elevated ALT, serum HBV DNA?2000
IU/ml were randomized 1:1 at baseline to receive PEG-IFN 180 mcg/week
for 24 weeks followed by LdT 600 mg/die for 24 weeks (PEG-IFN first), or
vice versa (LdT first), plus 24-week follow-up; HCV, HDV or HIV
coinfections and lamivudine-resistance were excluded. Primary endpoints
were serum HBV DNA <2000 IU/ml and normal ALT at week 72.Results Thirty
patients (86% male; median age, 48 years) were enrolled: baseline serum
HBV DNA, 5.56±1.4 Log IU/ml; mean ALT 2.9±2.5 times normal. At end of
follow-up (week 72), HBV DNA<2000 IU/ml was achieved in 13.3% in PEG-IFN
first group vs. 46.7% in LdT first group (p=0.046). Mean ALT levels were
significantly lower in LdT first group (1.3±0.9 vs. 3.2±2.7 times
normal, p=0.03).PEG-IFN dose was reduced in 2 patients (7%). One patient
(7%) dropped out due to myalgia.Conclusion Sequential treatment with 24
weeks PEG-IFN followed or preceded by 24 weeks of LdT is safe.
Virological response rate at week 72 was significantly higher in
patients treated with LdT followed by PEG-IFN than vice versa. A
sequential antiviral regimen of LdT followed by PEG-IFN, if confirmed in
larger series, could improve response rates compared to standard PEG-IFN
monotherapy.

[4est]

this was publish on this month,

http://www.ncbi.nlm.nih.gov/pubmed/22872648

so I don'tthisnk that is teh one from 2 years ago, but is posible.

anyway, it seams that our guesing that firt NUC and after that INF have a base and is possible to become a treatment indication, but we have a lot of possible combination and we should pick the correct one for each of us.

[veteranB]

this is good news.

I wish they treat people more this way...

[stef2011]

this is 1-2 years ago, i remember a post of an italian guy who cleared hbv on this treatment before 48 weeks, they stop intf after 48weeks because it continues to work for 5-10 years after you stop, some relapse but i guess the most have sustained response, today we know those with hbsg 1000iu/ml or less continue to clear after they stop intf while most of those with higher hbsag at end of treat relapse

[4est]

Could you check if the monitoring continues ? (and if some other results are available)

IS interesting that this guys were under treatment only for 48 weeks and as far as in understood they stop all treatments.

[veteranB]

they knew this is as far back as 6 years ago. Some doctors I have seen were telling me this, yet none dared to try it.