恩替卡韦预防接受R-CHOP治疗DLBCL患者的HBV再激活比拉米夫定更有效

关键信息

该随机、开放标签的III期试验显示，将121名接受R-CHOP治疗的乙肝病毒表面抗原阳性的患者随机分为联合使用恩替卡韦组(n=61)或联合使用拉米夫定组(n=60)，以评估这两种方案预防乙肝病毒 (HBV) 再激活的有效性。接受恩替卡韦治疗的患者患HBV相关乙肝的概率(0% vs 13.3%; P =0.003)，以及HBV 再激活的概率 (6.6% vs 30%; P =0.001) 和化疗中断的概率(1.6% vs 18.3%; P =0.002)均显著低于接受拉米夫定治疗的患者。接受恩替卡韦治疗的患者更少发生治疗相关的不良事件(24.6% vs 30%)，虽然差异并不显著。

结果显示，与拉米夫定相比，在R-CHOP治疗中添加恩替卡韦能够显著降低HPV相关肝炎的发病率和HBV的再激活。

TAKE-HOME MESSAGE

In this randomized, open-label, phase III study, 121 patients seropositive for the hepatitis B surface antigen received R-CHOP plus either entecavir (n = 61) or lamivudine (n = 60) to assess the efficacy of these agents in preventing hepatitis B virus (HBV) reactivation. The rate of HBV-related hepatitis was significantly lower in patients receiving entecavir vs lamivudine (0% vs 13.3%; P = .003), as were the rates of HBV reactivation (6.6% vs 30%; P = .001) and chemotherapy disruption (1.6% vs 18.3%; P = .002). Although not significant, fewer patients taking entecavir experienced treatment-related adverse events (24.6% vs 30%).

Results showed that entecavir added to R-CHOP chemotherapy resulted in a lower incidence of HPV-related hepatitis and HBV reactivation compared with lamivudine in this group of patients.

JAMA : The Journal of the American Medical Association

Entecavir vs Lamivudine for Prevention of Hepatitis B Virus Reactivation Among Patients With Untreated Diffuse Large B-Cell Lymphoma Receiving R-CHOP Chemotherapy: A Randomized Clinical Trial

JAMA 2014 Dec 17;312(23)2521-2530, H Huang, X Li, J Zhu, S Ye, H Zhang, W Wang, X Wu, J Peng, B Xu, Y Lin, Y Cao, H Li, S Lin, Q Liu, T Lin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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