| 5 | 金刚烷胺三联疗法治疗无应答型丙型肝炎患者显示文摘Background/Aims: To determine whether addition of amantadine to pegylated interferon/ribavirin improved response rates among chronic hepatitis C patients, non-responders to interferon/ ribavirin and study the dynamic of response. Methods: In a double blind, multicenter, randomized trial, 200 non-responder patients received pegylated interferon 1.5 μ g/kg per week and ribavirin 800- 1200 mg/day, plus either amantadine 200 mg/day or placebo for 48 weeks. Endpoints were virological responses, ALT normalization, and histological benefit overtime. Results: Twenty percent of all patients achieved a sustained virological response (SVR). This rate was 8% higher in the triple therapy group (24% ) compared with the double therapy group (16% ) (P=0.22). A better virological response rate at week 24 was observed in the triple regimen group (43 vs 29% ; P=0.06), which was lost at week 48 suggesting viral escape. The biochemical response rate was also significantly higher with triple therapy at week 12 (63 vs 49% ; P=0.05) and week 24 (64 vs 49% ; P=0.03). Fibrosis stabilized or improved in 77% of all patients. Conclusions: Re-treatment of interferon/ ribavirin non-responder patients should be encouraged since a substantial proportion benefits from retreat-ment with pegylated interferon/ribavirin ± amantadine. In triple therapy involving amantadine, a time wise response and an increased SVR rate in subgroups less prone to viral breakthrough suggest clues for existing controversies. | Maynard M. Pradat P. Bailly F. C. Trépo 孟欣颖(译) 王顺涛(校) | 2006 | 世界核心医学期刊文摘(胃肠病学分册)2006，2，8： | 1 |
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