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( Lai Wei ),( Mingxiang Zhang ),( Min Xu ),( Wan-Long Chuang ),( Wei Lu ),( Wen Xie ),( Zhansheng Jia ),( Guozhong Gong ),( Yueqi Li ),( Si Hyun Bae ),( Yong-Feng Yang ),( Qing Xie ),( Shumei Lin ),( 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: The efficacy/safety of daclatasvir (pan-genotypic NS5A inhibitor) plus asunaprevir (NS3 protease inhibitor) in interferon (± ribavirin)- ineligible/intolerant patients with chronic HCV genotype-1b infection from mainland China, Korea and Taiwan was investigated in a phase 3, open-label study. Methods: Patients received daclatasvir 60 mg (tablet) once daily plus asunaprevir 100 mg (soft capsule) twice daily for 24 weeks. The primary endpoint was sustained virologic response at post-treatment Week 24 (SVR24). Results: This study treated 159 patients from mainland China (80%), Korea (11%) and Taiwan (9%), including patients with cirrhosis (33%), IL28B non-CC genotypes (40%), and aged ≥70 years (4%). SVR24 was achieved by 91% of patients (100% concordance with SVR12) and was similarly high in all subgroups, e.g. cirrhotic patients (90%), and in patients from mainland China (91%), Korea (94%) and Taiwan (87%). SVR24 was higher in patients without baseline NS5A (L31M/Y93H) resistance-associated variants (RAVs) (n=137/139 [99%]), regardless of the presence (98%) or absence (99%) of cirrhosis, and lower in patients with baseline NS5A RAVs (n=8/19 [42%]). All serious adverse events (AEs) (n=5/159 [3.1%]), grade 4 laboratory abnormalities (n=3/159 [1.9%]) and deaths (n=1/159 [0.6%]) that occurred on-treatment were unrelated to the study drugs; two patients discontinued due to AEs. Treatment was generally well tolerated regardless of cirrhosis status. Conclusions: Daclatasvir plus asunaprevir achieved a high SVR24 rate of 91%, rising to 99% in patients without baseline NS5A RAVs, and was generally well tolerated in cirrhotic and non-cirrhotic interferon (± ribavirin)-ineligible/intolerant patients with HCV genotype-1b infection from mainland China, Korea and Taiwan.