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Peginterferon add‐on results in more HBsAg decline compared to monotherapy in HBeAg‐positive chronic hepatitis B patients
Author(s) -
Brouwer W. P.,
Sonneveld M. J.,
Xie Q.,
Guo S.,
Zhang N.,
Zeuzem S.,
Tabak F.,
Zhang Q.,
Simon K.,
Akarca U. S.,
StreinuCercel A.,
Hansen B. E.,
Janssen H. L. A.
Publication year - 2016
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12468
Subject(s) - hbsag , medicine , entecavir , gastroenterology , peg ratio , hbeag , combination therapy , discontinuation , lamivudine , hepatitis b virus , peginterferon alfa 2a , hepatitis b , chronic hepatitis , immunology , virus , finance , ribavirin , economics
Summary It is unknown whether peginterferon ( PEG ‐ IFN ) add‐on to entecavir ( ETV ) leads to more HB sAg decline compared to PEG ‐ IFN monotherapy or combination therapy, and whether ETV therapy may prevent HB sAg increase after PEG ‐ IFN cessation. We performed a post hoc analysis of 396 HB eAg‐positive patients treated for 72 weeks with ETV + 24 weeks PEG ‐ IFN add‐on from week 24 to 48 (add‐on, n = 85), 72 weeks with ETV monotherapy ( n = 90), 52 weeks with PEG ‐ IFN monotherapy ( n = 111) and 52 weeks PEG ‐ IFN + lamivudine (combination, n = 110) within 2 randomized trials. HB sAg decline was assessed at the end of PEG ‐ IFN ( EOP ) and 6 months after PEG ‐ IFN ( EOF ) discontinuation. Differences in baseline characteristics were accounted for using inversed probability of treatment weights. At EOP , a HB sAg reduction of ≥1log 10 IU / mL was more frequently achieved for patients in the add‐on or combination therapy arms (both 36%), compared to PEG ‐ IFN mono (20%) or ETV (8%) (add‐on vs PEG ‐ IFN mono P = 0.050). At EOF , the HB sAg reduction ≥1log 10 IU / mL was only sustained in patients treated with ETV consolidation (add‐on vs combination and PEG ‐ IFN mono: 40% vs 23% and 18%, P = 0.029 and P = 0.003, respectively). For add‐on, combination, PEG ‐ IFN mono and ETV , the mean HB sAg‐level change at EOF was −0.84, −0.81, −0.68 and −0.33 log 10 IU / mL , respectively ( P > 0.05 for PEG ‐ IFN arms). HB eAg loss at EOF was 36%, 31%, 33% and 20%, respectively ( P > 0.05). PEG ‐ IFN add‐on for 24 weeks results in more on‐treatment HB sAg decline than does 52 weeks of PEG ‐ IFN monotherapy. ETV therapy may maintain the HB sAg reduction achieved with PEG ‐IFN.