December 2018

Monthly Archive

Second-line Treatments of Advanced Hepatocellular Carcinoma: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

Posted by on 24 Dec 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Second-line Treatments of Advanced Hepatocellular Carcinoma: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. J Clin Gastroenterol. 2018 Dec 19;: Authors: Bakouny Z, Assi T, El Rassy E, Nasr F Abstract BACKGROUND: Advanced hepatocellular carcinoma (HCC) constitutes the second leading cause of cancer-related deaths. First-line therapy is either sorafenib or lenvatinib. Several treatment options have been recently added to the second-line treatment of advanced HCC. The aim of this network meta-analysis of randomized controlled trials was to compare the second-line treatments of advanced HCC. METHODS: Network meta-analyses were computed for overall survival (OS), progression-free survival, rates of grade 3 to 5 adverse events, and for treatment discontinuation due to adverse events. OS was considered to be the primary outcome of this study, and everolimus was chosen to be the common comparator for efficacy analyses and placebo for safety analyses. Subgroup analyses were computed for OS in patients with hepatitis B, patients with hepatitis C, Asian patients, patients with macrovascular invasion, and patients with extrahepatic metastases. RESULTS: Thirteen randomized controlled trials including 5076 patients and evaluating 11 agents were found to be eligible. Regorafenib [hazard ratio (HR)=0.60, 95% confidence interval (CI)=0.44-0.81] and cabozantinib (HR=0.72, 95% CI=0.55-0.95) were found to significantly prolong OS compared with everolimus. The effect of regorafenib on OS tended to be conserved across patient subgroups. Regorafenib was also found to significantly prolong progression-free survival (HR=0.46, 95% CI=0.35-0.62) and significantly increase the rates of grade 3 to 5 adverse events (odds ratios=3.18, 95% CI=2.22-4.54) and treatment discontinuation due to adverse events (odds ratios=2.67, 95% CI=1.21-5.87). CONCLUSIONS: This network meta-analysis concludes that, based on current evidence, regorafenib could be the agent of choice in the second-line treatment of HCC, with cabozantinib as a possible alternative for sorafenib-intolerant patients. PMID: 30575632 [PubMed – as supplied by publisher]

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Second-line Treatments of Advanced Hepatocellular Carcinoma: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

The Role of Hepatitis B Surface Antigen in Nucleos(t)ide Analogues Cessation among Asian Chronic Hepatitis B Patients: A Systematic Review.

Posted by on 19 Dec 2018 | Tagged as: Hepatitis B Alternative Medicine

The Role of Hepatitis B Surface Antigen in Nucleos(t)ide Analogues Cessation among Asian Chronic Hepatitis B Patients: A Systematic Review. Hepatology. 2018 Dec 18;: Authors: Liu J, Li T, Zhang L, Xu A Abstract In actual clinical practice, infinite nucleos(t)ide analogues (NAs) treatment for chronic hepatitis B virus (HBV) infection is unrealistic. The most commonly used endpoint is suppression of HBV DNA to undetectable levels with normalization of alanine aminotransferase (ALT). However, this criterion for cessation of treatment is associated with various incidences of virological and clinical relapse. Recent studies suggest that decreasing hepatitis B surface antigen (HBsAg) level at the end of treatment (EOT) to an appropriate cutoff value appears to be a practicable and attainable cessation criterion. We performed a systematic review to explore the optimal cutoff value of HBsAg at EOT for the cessation of NAs treatment. Eleven studies with 1716 patients were included in this review. When the HBsAg levels at EOT were < 100 IU/mL and > 100 IU/mL, the respective off-therapy virological relapse rates were 9.1 (range) and 31.4 (range) at ≥ 12 months off-therapy regardless of HBeAg status, the respective off-therapy clinical relapse rates were 15.4 (range) and 48.1 (range) at ≥ 12 months off-therapy regardless of HBeAg status, and the respective off-therapy HBsAg loss rates were 21.1 (range) and 3.3 (range) for HBeAg-negative patients at ≥ 39 months off-therapy. Conclusion: Cessation of long-term NAs therapy prior to HBsAg seroclearance in patients with chronic hepatitis B is a feasible alternative to indefinite treatment. A HBsAg level < 100 IU/mL at EOT seems to be a useful marker for deciding when to discontinue NAs therapy. However, regular monitoring is required after the cessation of NAs treatment, and long-term outcomes must be further evaluated. This article is protected by copyright. All rights reserved. PMID: 30561829 [PubMed – as supplied by publisher]

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The Role of Hepatitis B Surface Antigen in Nucleos(t)ide Analogues Cessation among Asian Chronic Hepatitis B Patients: A Systematic Review.

Emergence of oncogenic-enhancing hepatitis B virus X gene mutants in patients receiving suboptimal entecavir treatment.

Posted by on 16 Dec 2018 | Tagged as: Hepatitis B Alternative Medicine

Emergence of oncogenic-enhancing hepatitis B virus X gene mutants in patients receiving suboptimal entecavir treatment. Hepatology. 2018 Dec 15;: Authors: Lin CL, Chu YD, Yeh CT Abstract Entecavir is a widely used nucleoside analogue for antiviral therapy against chronic hepatitis B virus (HBV) infection. Despite its remarkable efficacy in suppressing HBV replication, a substantial proportion of cirrhotic patients still developed hepatocellular carcinoma (HCC) after entecavir treatment (1). Presumably, it is largely attributed to the existing precancerous hepatocytes, which sturdily progresses into cancer despite effective viral suppression. HBV X (HBx) protein is a well-known oncogenic protein. Here, we explored an alternative possibility that oncogenic-enhancing mutations developed in HBx in HCC patients having received entecavir treatment. This article is protected by copyright. All rights reserved. PMID: 30552766 [PubMed – as supplied by publisher]

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Emergence of oncogenic-enhancing hepatitis B virus X gene mutants in patients receiving suboptimal entecavir treatment.

Systems Pharmacology-based strategy to screen new adjuvant for hepatitis B vaccine from Traditional Chinese Medicine Ophiocordyceps sinensis.

Posted by on 12 Dec 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Systems Pharmacology-based strategy to screen new adjuvant for hepatitis B vaccine from Traditional Chinese Medicine Ophiocordyceps sinensis. Sci Rep. 2017 03 20;7:44788 Authors: Wang J, Liu R, Liu B, Yang Y, Xie J, Zhu N Abstract Adjuvants are common component for many vaccines but there are still few licensed for human use due to low efficiency or side effects. The present work adopted Systems Pharmacology analysis as a new strategy to screen adjuvants from traditional Chinese medicine. Ophiocordyceps sinensis has been used for many years in China and other Asian countries with many biological properties, but the pharmacological mechanism has not been fully elucidated. First in this study, 190 putative targets for 17 active compounds in Ophiocordyceps sinensis were retrieved and a systems pharmacology-based approach was applied to provide new insights into the pharmacological actions of the drug. Pathway enrichment analysis found that the targets participated in several immunological processes. Based on this, we selected cordycepin as a target compound to serve as an adjuvant of the hepatitis B vaccine because the existing vaccine often fails to induce an effective immune response in many subjects. Animal and cellular experiments finally validated that the new vaccine simultaneously improves the humoral and cellular immunity of BALB/c mice without side effects. All this results demonstrate that cordycepin could work as adjuvant to hepatitis b vaccine and systems-pharmacology analysis could be used as a new method to select adjuvants. PMID: 28317886 [PubMed – indexed for MEDLINE]

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Systems Pharmacology-based strategy to screen new adjuvant for hepatitis B vaccine from Traditional Chinese Medicine Ophiocordyceps sinensis.