Telbivudine治疗慢性乙型肝炎。

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Telbivudine治疗慢性乙型肝炎。

阿你。2009年2月,26 (2):155 - 69。doi: 10.1007 / s12325 - 009 - 0004 - y。Epub 2009年2月18日。

PubMed ID

19225726 (在PubMed

]

文摘

简介:治疗慢性乙型肝炎病毒(HBV)感染已彻底改变了过去十年增加了可用性的有效的抗病毒药物。Telbivudine是一个结构相关的L-nucleoside拉米夫定,最近被批准用于慢性乙型肝炎病毒感染患者。Telbivudine高度选择性的HBV DNA和DNA合成抑制病毒对人类DNA或其它病毒没有影响。本文回顾了药理学,药物动力学,telbivudine治疗疗效和安全性,并探讨其在当前医疗设备对乙肝病毒。方法:Medline和相关出版物被确定搜索PubMed从2000年到2008年,使用搜索词“乙型肝炎/乙肝病毒,”“telbivudine / LdT,”“beta-L-thymidine”,“药物动力学,”“安全”“不良事件”和“抵抗”。The reference lists of retrieved articles were searched for relevant studies. RESULTS: Phase 3 clinical studies demonstrate that telbivudine is superior to lamivudine over a 2-year period in hepatitis B e-antigen (HBeAg)-positive and HBeAg-negative patients. Telbivudine was associated with a statistically significantly greater reduction in HBV DNA, greater proportion of alanine aminotransferase normalization, and greater histological response than lamivudine. Furthermore, telbivudine use resulted in fewer cases of treatment failure and less virological resistance than lamivudine. However, after 2 years of therapy, telbivudine resistance was appreciable (25%) and considerably higher than that seen with other new antivirals such as tenofovir and entecavir. Overall, telbivudine was found to be safe, although grade 3 or 4 adverse events, including elevations in creatine kinase, were more commonly found in patients receiving telbivudine than lamivudine. Telbivudine is not active against lamivudine-resistant HBV. CONCLUSIONS: Telbivudine is a new antiviral agent joining the armamentarium against HBV. It is superior to lamivudine in terms of therapeutic response and resistance profile. However, concerns about resistance with long-term use, along with inferior cost-effective analyses, have relegated telbivudine to a second-line agent in the management of chronic HBV infection.

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药物靶点

药物	目标	类	生物	药理作用	行动
Telbivudine	DNA	核苷酸	人类	是的	不可用	细节
Telbivudine	蛋白P	蛋白质	HBV-F	是的	不可用	细节