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丙肝1型索菲布韦+利巴韦林治愈率(svr24)68-90%---美国医学会杂志

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原文:Sofosbuvir and Ribavirin for Hepatitis C Genotype 1 in Patients With Unfavorable Treatment Characteristics
8月28日, 2013, Vol 310, No. 8------《美国医学会杂志》
说明:
本次参加测试人员总数为60人,分为两部分,10人和50人,种族:白人、黑人、西班牙裔
**肝病程度:皆为肝纤维化程度以上,4人为肝硬(肝穿活检确定级别)
用药时间:索菲+利巴 24周
Il28b 分型:cc型,11人,ct/tt型 48人
第一部分:参加试验10人,完成9人,肝纤维化0-1级(轻微),**未经治疗
9人获得svr24,即用药结束后24周病毒未检测到。治愈率90%
第二部分:分为两组,各25人,肝纤维化3-4级或肝硬化
一组:索菲1片+标准剂量利巴韦林(1000mg-1200mg)完成试验24人。停药24周后(SVR24),治愈率为68%
二组:索菲1片+低剂量利巴韦林(600mg)完成试验22人。停药24周后(SVR24),治愈率为48%
Results
In the first part of the study, 9 participants achieved SVR24.
In the second part, 7 participants (28%) in the weight-based group and 10 (40%) in the low-dose group relapsed after treatment completion leading to SVR24 rates of 68% in the weight-based group and 48% in the low-dose group.
总结:本次试验中,
1、正常利巴韦林剂量,低肝纤维化治愈率90%,
2、正常利巴韦林剂量,高肝纤维化或肝硬化治愈率68%
3、低利巴韦林剂量(600MG),高肝纤维化或肝硬化治愈率48%,由此可见,利巴剂量非常重要
此外,同期新西兰一试验中,索菲+标准剂量利巴,治愈率为84%。由此推断,低纤维化非肝硬化治愈率可达80%左右
The overall SVR rate achieved by participants who received sofosbuvir in combination with weight-based ribavirin in our study was 68% compared with the 84% reported in a recent New Zealand study of sofosbuvir and weight-based ribavirin in a predominantly white, treatment-naive population


1楼2015-07-12 15:52回复
    索菲布韦+利巴韦林,仅此二联,应答率90%以上,即,几乎每个人,不论是否肝硬化,用药早期或期间都会出现病毒转阴或下降,当然后期不能确定每个人都SVR24不会复发
    见文章:
    Sofosbuvir and Ribavirin for the Treatment of Chronic HCV With Cirrhosis and Portal Hypertension With and Without Decompensation: Early Virologic Response and Safety
    现在欧美1型治疗方案已经都改为harvoni或艾伯维,已经没人用这个方案!
    这个试验时间是在2013年8月


    2楼2015-07-12 15:54
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      2025-08-05 01:02:49
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      原文:Hepatitis C treatment factsheet Sofosbuvir (Sovaldi) ------2014年4月 infohep网站


      3楼2015-07-12 15:55
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        经过文献检索,找到一个肝弹分级图,
        但该文明确指出:现在没有统一临界值,所以仅供参考,不作为临床诊断依据
        具体你的肝弹分级请咨询你的临床医生!


        4楼2015-07-12 15:57
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          不论索菲+利巴还是harvoni,及harvoni+第3种DAA,病毒初期下降非常快,
          病毒下降曲线图


          5楼2015-07-12 15:57
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            上帖曲线图来源文章:
            The Paradox of Highly Effective Sofosbuvir Combo Therapy Despite Slow Viral Decline
            文章结论就不翻译了,呵呵!结论要留待以后验证。希望结论是对的!
            Consistent with this slow final phase, the model predicted SVR rate of 85.2% after 24 weeks of SOF+RBV, but only 43% and 10% after 12 and 6 weeks of SOF+LDV and SOF+LDV+GS9669/GS9451, respectively, i.e., much lower than what was observed in the Synergy trial.
            Conclusions: The kinetics of viral decline in patients of the Synergy trial was remarkably slow in regard of the very rapid cure of HCV. This suggests that HCV RNA is not a reliable marker for predicting outcome of treatment containing SOF+LDV. Additional mechanisms of action that are not reflected in the observed viral load, such as production of non-infectious virus, may explain the high cure rates.


            6楼2015-07-12 15:58
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              一个索非二联3型SVR24案例
              网名:patra_ Jun 11, 2015
              Gender: Female
              Age: 73
              Ht/Wt: 5ft 4 in; 169
              Genotype: 3
              VL at start: 813,096
              What Treatment: Sovaldi/Ribavirin
              How Long: 24 weeks
              Date completed 12-01-2014
              SVR or Relapse: SVR12 and now SVR24 (Yay!)
              Liver Status: F3, A0/A1 on biopsy 01-31-2014
              Naive or Prior treatment: Interferon Injections 3 x week 7 months 94/95
              Additional Comments:
              So blessed! Many negatives: Female, over menopause age, over weight, treated before, Fibrosis, Level 3, Gt3 and still reached SVR! next Labs AFP and Viral Load only in 6 months (more for my peace of mind than his, I think!)
              Positives: Followed instructions about meds, drank LOTS of water, changed diet to liver friendly foods, lost 28 lbs and sticking to the regimen! So grateful!


              9楼2015-09-07 13:51
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                网名:Ekkiemom (1a型、索非+利巴韦林24周,SVR24)
                Apr 11, 2015
                Gender: F
                Ht/Wt: 5.5/ 152
                Genotype: 1a
                VL: first Tx. 31.5 mil
                Tx: INF/INCIVEK/RIBA
                How long: 5 wks
                SVR / Relapse had to stopped Tx bcuz of SFX
                VL: 2nd Tx 11.5 mil
                Tx: Sovaldi/RIBA (索非+利巴韦林二联)
                How long: 24 wks
                SVR/Relapse: ********SVR!!!!!!!!!!!!!!!!!!! 24wks*************
                Comments
                THANKS GILEAD!!!!!!!!!!! And each week I feel so much better.. wooooohooooo! don't give up the fight DRAGONSLAYERS!!


                10楼2015-09-07 15:18
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                  2025-08-05 00:56:49
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                  一个索非+利巴韦林 24周 3型案例
                  网名:monavenir (3型索非+利巴韦林24周,SVR12)
                  Dec 04, 2014
                  Gender: female
                  Ht/Wt: 5.3 / 115
                  Age: 52
                  Genotype : 3
                  Prior treatment with interferon riba in 2009
                  IL28B: CT
                  Liver statut: F0-F1
                  VL at start in March 2014: 600 000
                  Treatment : sovaldi and RIBA 24 weeks
                  SVR or Relapse: SVR 12 weeks!
                  Now waiting for SVR 24!!! Than I can say CURE!
                  So happy to be SVR


                  11楼2015-09-07 16:12
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