Prediction of Sustained Response After Nucleo(s)tide Analogue Cessation Using HBsAg and HBcrAg Levels: A Multicenter Study (CREATE): A Multicenter Study (CREATE)
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| Názov: | Prediction of Sustained Response After Nucleo(s)tide Analogue Cessation Using HBsAg and HBcrAg Levels: A Multicenter Study (CREATE): A Multicenter Study (CREATE) |
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| Autori: | Sonneveld, Milan, Park, Jun Yong, Kaewdech, Apichat, Seto, Wai-Kay, Tanaka, Yasuhito, Carey, Ivana, Papatheodoridi, Margarita, van Bömmel, Florian, Berg, Thomas, Zoulim, Fabien, Ahn, Sang Hoon, Dalekos, George, Erler, Nicole, Höner zu Siederdissen, Christoph, Wedemeyer, Heiner, Cornberg, Markus, Yuen, Man-Fung, Agarwal, Kosh, Boonstra, Andre, Buti, Maria, Piratvisuth, Teerha, Papatheodoridis, George, Maasoumy, Benjamin |
| Prispievatelia: | Manship, Brigitte, Milan J Sonneveld, Jun Yong Park, Apichat Kaewdech, Wai-Kay Seto, Yasuhito Tanaka, Ivana Carey, Margarita Papatheodoridi, Florian van Bömmel, Thomas Berg, Fabien Zoulim, Sang Hoon Ahn, George N Dalekos, Nicole S Erler, Christoph Höner Zu Siederdissen, Heiner Wedemeyer, Markus Cornberg, Man-Fung Yuen, Kosh Agarwal, Andre Boonstra, Maria Buti, Teerha Piratvisuth, George Papatheodoridis, Benjamin Maasoumy, Park, Jun Yong |
| Zdroj: | Clinical Gastroenterology and Hepatology. 20:e784-e793 |
| Informácie o vydavateľovi: | Elsevier BV, 2022. |
| Rok vydania: | 2022 |
| Predmety: | Hepatitis B Surface Antigens, 0301 basic medicine, Hepatitis B virus, Antiviral Agents / therapeutic use, Antiviral Agents, 12. Responsible consumption, 03 medical and health sciences, HBsAg, Hepatitis B, Chronic, SDG 3 - Good Health and Well-being, Humans, Viral, 0303 health sciences, DNA, Sustained Response, Hepatitis B, Chronic, Hepatitis B Core Antigens, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, SCALE-B, DNA, Viral, Hepatitis B virus / genetics, HBcrAg |
| Popis: | Predictors of successful nucleo(s)tide analogue (NA) therapy withdrawal remain elusive. We studied the relationship between end-of-treatment levels of hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg) and outcome after therapy cessation.Patients who discontinued NA therapy in centers in Asia and Europe were enrolled. HBcrAg and HBsAg were measured at treatment cessation, and associations with off-treatment outcomes were explored. The SCALE-B (Surface antigen, Core-related antigen, Age, ALT, and tenofovir for HBV) score was calculated as previously reported. End points included sustained virologic response (VR; hepatitis B virus DNA level 3× upper limit of normal). Re-treated patients were considered nonresponders.We analyzed 572 patients, 457 (80%) were Asian and 95 (17%) were hepatitis B e antigen positive at the start of NA therapy. The median treatment duration was 295 weeks. VR was observed in 267 (47%), HBsAg loss was observed in 24 (4.2%), and ALT flare was observed in 92 (16%). VR (67% vs 42%) and HBsAg loss (15% vs 1.5%) was observed more frequently in non-Asian patients when compared to Asian patients (P < .001). Lower HBcrAg levels were associated with higher rates of VR (odds ratio [OR], 0.701; P < .001) and HBsAg loss (OR, 0.476; P < .001), and lower rates of ALT flares (OR, 1.288; P = .005). Similar results were observed with HBsAg (VR: OR, 0.812; P = .011; HBsAg loss: OR, 0.380; P < .001; and ALT flare: OR, 1.833; P < .001). Lower SCALE-B scores were associated with higher rates of VR, HBsAg loss, and lower rates of ALT flares in both Asian and non-Asian patients (P < .001).In this multicenter study, off-treatment outcomes after NA cessation varied with ethnicity. Lower levels of HBcrAg and HBsAg were associated with favorable outcomes. A risk score comprising both factors can be used for risk stratification. |
| Druh dokumentu: | Article |
| Jazyk: | English |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2020.12.005 |
| Prístupová URL adresa: | http://www.cghjournal.org/article/S1542356520316621/pdf https://pubmed.ncbi.nlm.nih.gov/33309804 https://hal.science/hal-04012155v1 https://doi.org/10.1016/j.cgh.2020.12.005 https://pure.eur.nl/en/publications/2c464d03-6b88-41a5-8a89-70493e09042d https://doi.org/10.1016/j.cgh.2020.12.005 https://www.ncbi.nlm.nih.gov/pubmed/33309804 https://www.sciencedirect.com/science/article/pii/S1542356520316621 https://pubmed.ncbi.nlm.nih.gov/33309804/ https://www.cghjournal.org/article/S1542-3565(20)31662-1/fulltext |
| Rights: | CC BY CC BY NC ND |
| Prístupové číslo: | edsair.doi.dedup.....b6d5a1a431840ac4a4ad82b2c6ed8db9 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Predictors of successful nucleo(s)tide analogue (NA) therapy withdrawal remain elusive. We studied the relationship between end-of-treatment levels of hepatitis B core-related antigen (HBcrAg) and hepatitis B surface antigen (HBsAg) and outcome after therapy cessation.Patients who discontinued NA therapy in centers in Asia and Europe were enrolled. HBcrAg and HBsAg were measured at treatment cessation, and associations with off-treatment outcomes were explored. The SCALE-B (Surface antigen, Core-related antigen, Age, ALT, and tenofovir for HBV) score was calculated as previously reported. End points included sustained virologic response (VR; hepatitis B virus DNA level 3× upper limit of normal). Re-treated patients were considered nonresponders.We analyzed 572 patients, 457 (80%) were Asian and 95 (17%) were hepatitis B e antigen positive at the start of NA therapy. The median treatment duration was 295 weeks. VR was observed in 267 (47%), HBsAg loss was observed in 24 (4.2%), and ALT flare was observed in 92 (16%). VR (67% vs 42%) and HBsAg loss (15% vs 1.5%) was observed more frequently in non-Asian patients when compared to Asian patients (P < .001). Lower HBcrAg levels were associated with higher rates of VR (odds ratio [OR], 0.701; P < .001) and HBsAg loss (OR, 0.476; P < .001), and lower rates of ALT flares (OR, 1.288; P = .005). Similar results were observed with HBsAg (VR: OR, 0.812; P = .011; HBsAg loss: OR, 0.380; P < .001; and ALT flare: OR, 1.833; P < .001). Lower SCALE-B scores were associated with higher rates of VR, HBsAg loss, and lower rates of ALT flares in both Asian and non-Asian patients (P < .001).In this multicenter study, off-treatment outcomes after NA cessation varied with ethnicity. Lower levels of HBcrAg and HBsAg were associated with favorable outcomes. A risk score comprising both factors can be used for risk stratification. |
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| ISSN: | 15423565 |
| DOI: | 10.1016/j.cgh.2020.12.005 |