Background: Peginterferon induces off-treatment responses in approximately one-third of patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Aim: To develop an easy-to-use baseline prediction score to identify hepatitis B virus (HBV) genotype B-/C-infected HBeAg-positive Asian patients likely to respond to peginterferon alfa-2a. Methods: Generalised additive models, multiple logistic regression (MLR) analysis and internal validation methods were applied to data from 647 HBeAg-positive patients from China, Hong Kong and Taiwan to develop a scoring system to predict response 24weeks after completing a 48-week course of peginterferon alfa-2a. Results: Five baseline factors (age, sex, alanine aminotransferase ratio, hepatitis B surface antigen (HBsAg) level and HBV DNA level) were retained in the final MLR for HBeAg seroconversion and used to develop a scoring system from 0 to 7. Among patients with scores of 0-1, 2-3, 4 or >= 5, HBeAg seroconversion was achieved in 6.4% (6/94), 23.0% (61/265), 36.4% (67/184) and 54.8% (57/104), respectively, and a combined response (HBeAg seroconversion plus HBV DNA >= 2000 IU/mL) in 5.3% (5/94), 12.8% (34/265), 25.0% (46/184) and 36.5% (38/104), respectively. Among patients with scores of 0-1, 2-3, 4 or 5, 57.0% (53/93), 12.3% (31/253), 3.4% (6/178) and 1.0% (1/100) had HBsAg >= 20000 IU/mL at treatment Week 12; only 3/91 (3.3%) with HBsAg >= 20000 IU/mL experienced a combined response at 24 weeks post-treatment (negative predictive value=97% [88/91]). Conclusion: A pre-treatment scoring system using readily available baseline characteristics identifies HBeAg-positive Asian patients likely to experience sustained HBeAg seroconversion after treatment with peginterferon alfa-2a.

A baseline tool for predicting response to peginterferon alfa-2a in HBeAg-positive patients with chronic hepatitis B / H.L.Y. Chan, D. Messinger, G.V. Papatheodoridis, M. Cornberg, Q. Xie, T. Piratvisuth, H. Ren, P.T. Kennedy, A. Thompson, A. Caputo, G. Bakalos, V. Pavlovic, P. Lampertico. - In: ALIMENTARY PHARMACOLOGY & THERAPEUTICS. - ISSN 0269-2813. - 48:5(2018 Sep), pp. 547-555. [10.1111/apt.14862]

A baseline tool for predicting response to peginterferon alfa-2a in HBeAg-positive patients with chronic hepatitis B

P. Lampertico
Ultimo
2018

Abstract

Background: Peginterferon induces off-treatment responses in approximately one-third of patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. Aim: To develop an easy-to-use baseline prediction score to identify hepatitis B virus (HBV) genotype B-/C-infected HBeAg-positive Asian patients likely to respond to peginterferon alfa-2a. Methods: Generalised additive models, multiple logistic regression (MLR) analysis and internal validation methods were applied to data from 647 HBeAg-positive patients from China, Hong Kong and Taiwan to develop a scoring system to predict response 24weeks after completing a 48-week course of peginterferon alfa-2a. Results: Five baseline factors (age, sex, alanine aminotransferase ratio, hepatitis B surface antigen (HBsAg) level and HBV DNA level) were retained in the final MLR for HBeAg seroconversion and used to develop a scoring system from 0 to 7. Among patients with scores of 0-1, 2-3, 4 or >= 5, HBeAg seroconversion was achieved in 6.4% (6/94), 23.0% (61/265), 36.4% (67/184) and 54.8% (57/104), respectively, and a combined response (HBeAg seroconversion plus HBV DNA >= 2000 IU/mL) in 5.3% (5/94), 12.8% (34/265), 25.0% (46/184) and 36.5% (38/104), respectively. Among patients with scores of 0-1, 2-3, 4 or 5, 57.0% (53/93), 12.3% (31/253), 3.4% (6/178) and 1.0% (1/100) had HBsAg >= 20000 IU/mL at treatment Week 12; only 3/91 (3.3%) with HBsAg >= 20000 IU/mL experienced a combined response at 24 weeks post-treatment (negative predictive value=97% [88/91]). Conclusion: A pre-treatment scoring system using readily available baseline characteristics identifies HBeAg-positive Asian patients likely to experience sustained HBeAg seroconversion after treatment with peginterferon alfa-2a.
Settore MED/12 - Gastroenterologia
set-2018
29-giu-2018
Article (author)
File in questo prodotto:
File Dimensione Formato  
Chan_et_al-2018-Alimentary_Pharmacology_%26_Therapeutics.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 786.54 kB
Formato Adobe PDF
786.54 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/580440
Citazioni
  • ???jsp.display-item.citation.pmc??? 6
  • Scopus 23
  • ???jsp.display-item.citation.isi??? 19
social impact