Thymosin alpha1 treatment of chronic hepatitis B: results of a phase III multicentre, randomized, double-blind and placebo-controlled study |
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Authors: | Mutchnick M G Lindsay K L Schiff E R Cummings G D Appelman H D Peleman R R Silva M Roach K C Simmons F Milstein S Gordon S C Ehrinpreis M N |
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Institution: | Division of Gastroenterology, Department of Medicine, Wayne State University School of Medicine, Detroit, MI,,;Division of Gastrointestinal and Liver Diseases, Department of Medicine, University of Southern California, Los Angeles, CA,,;Center for Liver Diseases, University of Miami School of Medicine and the Veterans Affairs Medical Center, Miami, FL and,;Department of Pathology, University of Michigan, Ann Arbor, MI, USA |
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Abstract: | Previous clinical trials have suggested that thymosin α1 (Tα1), an immunomodulatory peptide, may be effective in the treatment of chronic hepatitis B (CHB). The aim of this study was to determine the efficacy of Tα1 in a multicentre, placebo-controlled and double-blind study of 97 patients with serum hepatitis B virus (HBV) DNA- and hepatitis B e antigen (HBeAg)-positive CHB. Patients who had been hepatitis B surface antigen (HBsAg) positive for at least 12 months entered a 3-month screening period prior to randomization. Forty-nine patients received Tα1 (1.6 mg) and 48 patients received placebo, twice weekly for 6 months, and were followed-up for an additional 6 months. At inclusion, both groups were comparable for age, gender, histological grading, and aminotransferase and HBV DNA levels. A complete response to treatment, defined as a sustained serum HBV DNA-negative status (two negative results at least 3 months apart) during the 12-month study, with negative HBV DNA and HBeAg values at month 12, was seen in seven (14%) patients given Tα1 and in two (4%) patients treated with placebo ( P = 0.084). Five (10%) patients given Tα1 and four (8%) patients given placebo exhibited a delayed response (defined as sustained serum HBV DNA negativity achieved after the 12-month study period with negative HBV DNA and HBeAg values at the last assessment). A total of 12 (25%) patients given Tα1 and six (13%) patients given placebo showed a sustained loss of HBV DNA with a negative HBeAg value during or following the 12-month study period ( P < 0.11). These results do not confirm observations of treatment efficacy reported in other clinical studies. |
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Keywords: | chronic hepatitis B thymosin treatment |
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