共查询到20条相似文献,搜索用时 15 毫秒
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Mustafa Kemal Celen Duygu Mert Müzeyyen Ay Tuba Dal Safak Kaya Necmettin Yildirim Serda Gulsun Tunga Barcin Sevgi Kalkanli Mehmet Sinan Dal Celal Ayaz 《World journal of gastroenterology : WJG》2013,19(48):9377-9382
AIM:To evaluate the effects of tenofovir disoproxil fumarate(TDF)use during late pregnancy to reduce hepatitis B virus(HBV)transmission in highly viremic mothers.METHODS:This retrospective study included 45 pregnant patients with hepatitis B e antigen(+)chronic hepatitis B and HBV DNA levels>107copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation(n=21).Untreated pregnant patients served as controls(n =24).All infants received 200 IU of hepatitis B immune globulin(HBIG)within 24 h postpartum and 20μg of recombinant HBV vaccine at 4,8,and 24 wk.Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28.RESULTS:At week 28,none of the infants of TDFtreated mothers had immunoprophylaxis failure,whereas2(8.3%)of the infants of control mothers had immunoprophylaxis failure(P=0.022).There were no differences between the groups in terms of adverse events in mothers or congenital deformities,gestational age,height,or weight in infants.At postpartum week 28,significantly more TDF-treated mothers had levels of HBV DNA<250 copies/mL and normalized alanine aminotransferase compared with controls(62%vs none,P<0.001;82%vs 61%,P=0.012,respectively).CONCLUSION:TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants. 相似文献
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1995年Dienstag等发现拉米夫定可抑制HBV DNA复制以来,以拉米夫定为代表的核苷(酸)类似物抗乙型肝炎病毒(HBV)的临床应用成为慢性乙型病毒性肝炎(CHB)治疗史上的里程碑,其问世推动了CHB治疗的进程。迄今为止,已有4种核苷(酸)类似物即拉米夫定(LMV)、阿德福韦酯(ADV)、恩替卡韦(ETV)和替比夫定(LdT)获得美国食品与药品管理局(FDA)批准用于慢性乙型病毒性肝炎的治疗。 相似文献
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Weixia Ke Chi Zhang Li Liu Yanhui Gao Zhenjiang Yao Xiaohua Ye Shudong Zhou Yi Yang 《Hepatology International》2016,10(6):924-936
Background
Tenofovir disoproxil fumarate (TDF) is newly available for treatment of chronic hepatitis B patients in China. To date, no study has been conducted to examine the cost-effectiveness of this treatment. The aim of this study was to estimate the cost-effectiveness of TDF versus four oral nucleos(t)ide analogs [lamivudine (LAM), adefovir (ADV), telbivudine (LdT), and entecavir (ETV)] and from a pharmacoeconomic perspective to assess current drug pricing for TDF.Methods
Based on Chinese healthcare perspectives, a Markov model was applied to simulate the lifetime (40-year time span) costs and quality-adjusted life-years (QALYs) for five different monotherapy strategies. Two kinds of rescue combination strategies (base-case: LAM + ADV then ETV + ADV; alternative: directly using ETV + ADV) were separately considered for treatment of patients refractory to monotherapy. Model parameters (including disease transition, cost, and utility) were obtained from previous Chinese population studies. Both branded and generic drugs were separately analyzed. Study model uncertainties were assessed by one-way and probabilistic sensitivity analyses. Two-way sensitivity analysis was used to explore uncertainties between efficacy and price of TDF.Results
In the base-case analysis, the lowest lifetime cost and the best cost-effectiveness ratio were obtained by ETV, which was considered the reference treatment. LAM, ADV, and LdT treatments had significantly greater costs and lower efficacies. Compared to ETV, TDF was more effective but also more expensive. The incremental cost-effectiveness ratios of TDF versus ETV were much higher than the willing-to-pay threshold of $20,466 US dollars (USD) per QALY gained (3 × gross domestic product per capita of China, 2014). TDF would be the most cost-effective strategy if the annual cost did not exceed $2260 USD and $1600 USD for branded and generic drugs, respectively.Conclusions
For Chinese chronic hepatitis B patients, ETV is still the most cost-effective strategy over TDF and other nucleos(t)ide analogs, with a threshold of $20,466 USD/QALY gained.10.
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治疗慢性乙型肝炎新药-替诺福韦酯 总被引:5,自引:0,他引:5
替诺福韦酯(TDF)是一种新型的无环核苷(酸)类似物,于2001年被美国FDA批准治疗人免疫缺陷病毒(HIV)的感染.目前TDF已经是广泛使用的治疗HIV的核苷(酸)类逆转录酶抑制剂之一.替诺福韦酯在临床实践中的效果,良好的适用性和合适的剂量均使其成为一线治疗的最流行药物之一.已有临床研究显示,TDF对合并感染HIV及乙型肝炎病毒(HBV)的患者具有较好的疗效.本文主要对TDF的研发背景、作用机制、药理学特点、不良反应、在CHB相关疾病方面的临床应用以及在治疗CHB的费用效能分析等方面的研究作一简要述评. 相似文献
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Shun Kaneko Masayuki Kurosaki Nobuharu Tamaki Jun Itakura Tsuguru Hayashi Sakura Kirino Leona Osawa Keiya Watakabe Mao Okada Wan Wang Takao Shimizu Mayu Higuchi Kenta Takaura Yutaka Yasui Kaoru Tsuchiya Hiroyuki Nakanishi Yuka Takahashi Mamoru Watanabe Namiki Izumi 《Journal of gastroenterology and hepatology》2019,34(11):2004-2010
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目的 探讨应用替诺福韦酯(TDF)挽救治疗HBV DNA聚合酶区204位点突变的经治的慢性乙型肝炎(CHB)患者的疗效及安全性。方法 2013年8月~2015年12月我院诊治的CHB患者87例,纳入患者均为曾接受拉米夫定(LAM)或阿德福韦酯(ADV)治疗6个月以上,血清HBV DNA阴转后又复阳,且经检测出现rtl204v耐药者,43例接受恩替卡韦(ETV)治疗,另44例接受TDF治疗,观察疗效,并使用流式细胞仪检测外周血CD4+T淋巴细胞计数,常规计算内生肌酐清除率(Crcl)。结果 在治疗24 w、48 w和72 w时,TDF治疗组血清HBV DNA阴转率分别为63.6%、79.6%和95.5%,显著高于ETV治疗组【分别为35.6%、55.6%和82.2%,P<0.05】,血清ALT复常率分别为84.1%、90.9%和93.2%,而ETV 治疗组则分别为65.1%(P<0.05)、83.7%和90.7%;TDF治疗组外周血CD4+T细胞计数分别为(481.5±232.4)/μl、(536.5±297.5)/μl和(566.5±321.6)/μl,与ETV治疗组比,无显著性差异【分别为(475.3±229.3)/μl、(565.8±255.9)/μl和(565.1±256.5)/μl,P<0.05】;Crcl分别为(101.2±40.1)ml/min、(104.3±26.8) ml/min和(98.7±21.5) ml/min,与ETV治疗组比,无显著性差异【分别为(105.2±42.6) ml/min、(102.5±30.6) ml/min和(99.6±26.8) ml/min,P<0.05】。结论 TDF和ETV挽救治疗对核苷(酸)类治疗耐药的经治CHB患者均有良好的疗效,但似乎TDF起效更快,而ETV用量较大,不应列为首选。 相似文献
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Juhan Lee Jun Yong Park Seok Jeong Yang Jee Youn Lee Deok Gie Kim Dong Jin Joo Myoung Soo Kim Soon Il Kim Jae Geun Lee 《Journal of viral hepatitis》2020,27(8):818-825
Potent nucleos(t)ide analogues and hepatitis B immunoglobulin combinations are recommended after liver transplantation to prevent the recurrence of hepatitis B virus (HBV). Despite its proven efficacy, the renal safety of tenofovir disoproxil fumarate (TDF) has not been well established in liver transplant recipients. We aimed to assess the impacts of TDF and entecavir (ETV) on tubular and glomerular functions. We analysed 206 liver transplant patients treated with TDF (n = 102) or ETV (n = 104) plus hepatitis B immunoglobulin. Serum creatinine, phosphate and uric acid levels were measured. Proximal tubular dysfunction was defined as the presence of hypophosphatemia (<2 mg/dL) and hypouricemia (<2 mg/dL). Glomerular dysfunction was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 accompanied by a ≥25% eGFR decline from baseline. During a median follow‐up of 42.5 months, 48 patients developed proximal tubular dysfunction (30.4% and 16.3% in the TDF and ETV groups; P = .017). Serum levels of phosphate and uric acid were significantly lower in the TDF group post‐LT. TDF (OR, 2.34; 95% CI, 1.16‐4.69; P = .017) and low body mass index (OR, 2.11; 95% CI, 1.06‐4.21; P = .034) were independent risk factors for proximal tubular dysfunction. The prevalence of glomerular dysfunction was not significantly different between the two groups (TDF 51.0% and ETV 54.8%; P = .582). TDF significantly increased the risk of proximal tubular dysfunction. Although the effect of TDF on glomerular function was comparable to that of ETV, glomerular dysfunction was common after liver transplant. 相似文献
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