Skip to main content
Top
Published in: Virology Journal 1/2009

Open Access 01-12-2009 | Review

Treatment with lamivudine versus lamivudine and thymosin alpha-1 for e antigen-positive chronic hepatitis B patients: a meta-analysis

Authors: Yuan-Yuan Zhang, En-Qiang Chen, Jin Yang, Yu-Rong Duan, Hong Tang

Published in: Virology Journal | Issue 1/2009

Login to get access

Abstract

Background

Currently, there is no evidence on the combination of lamivudine and thymosin alpha-1 on chronic hepatitis B patients. The aim of this study was to compare the effect of lamivudine monotherapy with that of lamivudine and thymosin alpha-1 combination therapy for the treatment of hepatitis B e antigen (HBeAg)-positive hepatitis B patients.

Results

We searched PUBMED (from 1966 onwards), EMBASE (from 1966), CBMdisk (Chinese Biomedical Database, from 1978), CNKI (National Knowledge Infrastructure, from 1980), the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. Eight trials (583 patients in total) were identified. The lamivudine and thymosin alpha-1 combination treatment was significantly superior to lamivudine treatment in terms of ALT normalization rate (80.2% vs. 68.8%, P = 0.01), virological response rate (84.7% vs. 74.9%, P = 0.002), and HBeAg seroconversion rate (45.1% vs. 15.2%, P < 0.00001).

Conclusion

Among HBeAg-positive patients, thymosin alpha-1 and lamivudine combination therapy may be more effective than lamivudine monotherapy, providing superior rates of biochemical response, virological response, and HBeAg seroconversion.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ocama P, Opio CK, Lee WM: Hepatitis B virus infection:current status. Am J Med 2005, 118: 1413. 10.1016/j.amjmed.2005.06.021CrossRefPubMed Ocama P, Opio CK, Lee WM: Hepatitis B virus infection:current status. Am J Med 2005, 118: 1413. 10.1016/j.amjmed.2005.06.021CrossRefPubMed
2.
go back to reference Lai CL, Ratziu V, Yuen MF, Poynard TL: Viral hepatitis B. Lancet 2003, 362: 2089-2094. 10.1016/S0140-6736(03)15108-2CrossRefPubMed Lai CL, Ratziu V, Yuen MF, Poynard TL: Viral hepatitis B. Lancet 2003, 362: 2089-2094. 10.1016/S0140-6736(03)15108-2CrossRefPubMed
3.
go back to reference Ganem D, Prince AM: Hepatitis B virus infection – natural history and clinical consequences. N Engl J Med 2004, 350: 1118-1129. 10.1056/NEJMra031087CrossRefPubMed Ganem D, Prince AM: Hepatitis B virus infection – natural history and clinical consequences. N Engl J Med 2004, 350: 1118-1129. 10.1056/NEJMra031087CrossRefPubMed
4.
go back to reference Farrell GC, Teoh NC: Management of chronic hepatitis B virus infection: a new era of disease control. Intern Med J 2006, 36: 100-113. 10.1111/j.1445-5994.2006.01027.xCrossRefPubMed Farrell GC, Teoh NC: Management of chronic hepatitis B virus infection: a new era of disease control. Intern Med J 2006, 36: 100-113. 10.1111/j.1445-5994.2006.01027.xCrossRefPubMed
5.
go back to reference Chien RN, Liaw YF: Thymalfasin for the treatment of chronic hepatitis B. Expert Rev Anti Infect Ther 2004, 2: 9-16. 10.1586/14787210.2.1.9CrossRefPubMed Chien RN, Liaw YF: Thymalfasin for the treatment of chronic hepatitis B. Expert Rev Anti Infect Ther 2004, 2: 9-16. 10.1586/14787210.2.1.9CrossRefPubMed
6.
go back to reference Liaw YF: Thymalfasin (thymosin-alpha 1) therapy in patients with chronic hepatitis B. J Gastroenterol Hepatol 2004,19(Suppl 12):73-75. 10.1111/j.1440-1746.2004.03633.xCrossRef Liaw YF: Thymalfasin (thymosin-alpha 1) therapy in patients with chronic hepatitis B. J Gastroenterol Hepatol 2004,19(Suppl 12):73-75. 10.1111/j.1440-1746.2004.03633.xCrossRef
7.
go back to reference Leung N: Treatment of chronic hepatitis B: case selection and duration of therapy. J Gastroenterol Hepatol 2002, 17: 409-414. 10.1046/j.1440-1746.2002.02767.xCrossRefPubMed Leung N: Treatment of chronic hepatitis B: case selection and duration of therapy. J Gastroenterol Hepatol 2002, 17: 409-414. 10.1046/j.1440-1746.2002.02767.xCrossRefPubMed
8.
go back to reference Iino S, Toyota J, Kumada H, Kiyosawa K, Kakumu S, Sata M, Suzuki H, Martins EB: The efficacy and safety of thymosin alpha-1 in Japanese patients with chronic hepatitis B;results from a randomized clinical trial. J Viral Hepat 2005, 12: 300-306. 10.1111/j.1365-2893.2005.00633.xCrossRefPubMed Iino S, Toyota J, Kumada H, Kiyosawa K, Kakumu S, Sata M, Suzuki H, Martins EB: The efficacy and safety of thymosin alpha-1 in Japanese patients with chronic hepatitis B;results from a randomized clinical trial. J Viral Hepat 2005, 12: 300-306. 10.1111/j.1365-2893.2005.00633.xCrossRefPubMed
9.
go back to reference Chien RN, Liaw YF: Thymalfasin for the treatment of chronic hepatitis B. Expert Rev Anti infect Ther 2004, 2: 9-16. 10.1586/14787210.2.1.9CrossRefPubMed Chien RN, Liaw YF: Thymalfasin for the treatment of chronic hepatitis B. Expert Rev Anti infect Ther 2004, 2: 9-16. 10.1586/14787210.2.1.9CrossRefPubMed
10.
go back to reference Schulof RA, Low TL, Thurman GB, Goldstein AL: Thymosins and other hormones of the thymus gland. Prog Clin Biol Res 1981, 58: 191-215.PubMed Schulof RA, Low TL, Thurman GB, Goldstein AL: Thymosins and other hormones of the thymus gland. Prog Clin Biol Res 1981, 58: 191-215.PubMed
11.
go back to reference Low TL, Goldstein AL: Thymosins: structure, function, and therapeutic applications. Thymus 1984, 6: 27-43.PubMed Low TL, Goldstein AL: Thymosins: structure, function, and therapeutic applications. Thymus 1984, 6: 27-43.PubMed
12.
go back to reference Gramenzi A, Cursaro C, Andreone P, Bernardi M: Thymalfasin:clinical pharmacology and antiviral applications. BioDrugs 1998, 9: 477-486. 10.2165/00063030-199809060-00005CrossRefPubMed Gramenzi A, Cursaro C, Andreone P, Bernardi M: Thymalfasin:clinical pharmacology and antiviral applications. BioDrugs 1998, 9: 477-486. 10.2165/00063030-199809060-00005CrossRefPubMed
13.
go back to reference Lau GK: Use of immunomodulatory therapy (other than interferon) for the treatment of chronic hepatitis B virus infection. J Gastro-enterol Hepatol 2000,15(Suppl 3):46-52. 10.1046/j.1440-1746.2000.02102.xCrossRef Lau GK: Use of immunomodulatory therapy (other than interferon) for the treatment of chronic hepatitis B virus infection. J Gastro-enterol Hepatol 2000,15(Suppl 3):46-52. 10.1046/j.1440-1746.2000.02102.xCrossRef
14.
go back to reference Lee HW, Lee JI, Um SH, Ahn SH, Chang HY, Park YK, Hong SP, Moon YM, Han KH: Combination therapy of thymosin alpha-1 and lamivudine for HBeAg positive chronic hepatitis B:A prospective randomized, comparative pilot study. Journal of Gastroenterology and Hepatology 2008, 23: 729-735. 10.1111/j.1440-1746.2008.05387.xCrossRefPubMed Lee HW, Lee JI, Um SH, Ahn SH, Chang HY, Park YK, Hong SP, Moon YM, Han KH: Combination therapy of thymosin alpha-1 and lamivudine for HBeAg positive chronic hepatitis B:A prospective randomized, comparative pilot study. Journal of Gastroenterology and Hepatology 2008, 23: 729-735. 10.1111/j.1440-1746.2008.05387.xCrossRefPubMed
15.
go back to reference Wu F, Yu H, Huang S: Effects of lamivudine and thymosin alpha1 combination therapy on patients with chronic hepatitis B. Zhonghua Gan Zang Bing Za Zhi 2002, 10: 218-219.PubMed Wu F, Yu H, Huang S: Effects of lamivudine and thymosin alpha1 combination therapy on patients with chronic hepatitis B. Zhonghua Gan Zang Bing Za Zhi 2002, 10: 218-219.PubMed
16.
go back to reference Lin BL, Huang GM, Zhang XH, Xie QF, Yang SJ, Zhou YP, Lu JX, Yao JL: Thymosin-α1 improving efficacy of lamivudine treatment in patients with chronic hepatitis B. Chinese Journal Infectious Disease 2003, 21: 217-220. Lin BL, Huang GM, Zhang XH, Xie QF, Yang SJ, Zhou YP, Lu JX, Yao JL: Thymosin-α1 improving efficacy of lamivudine treatment in patients with chronic hepatitis B. Chinese Journal Infectious Disease 2003, 21: 217-220.
17.
go back to reference Liang J, Xu LC, Xu CY: Clinical Observation of Lamivudine combined with Thymosinα1 in Treatment of Patients with chronic hepatitis B. Biomagnetism 2006, 6: 55-56. Liang J, Xu LC, Xu CY: Clinical Observation of Lamivudine combined with Thymosinα1 in Treatment of Patients with chronic hepatitis B. Biomagnetism 2006, 6: 55-56.
18.
go back to reference Li YL, Zhang LT: Clinical Observation on Effect of LAM and Thymosinα1 for Chronic Hepatitis B. Journal of Medical Forum 2005, 26: 33-36. Li YL, Zhang LT: Clinical Observation on Effect of LAM and Thymosinα1 for Chronic Hepatitis B. Journal of Medical Forum 2005, 26: 33-36.
19.
go back to reference Liu W: Clinical study on lamivudine combined with thymosin α1 in the treatment of chronic hepatitis B. Jilin Medicine 2005, 26: 1059-1060. Liu W: Clinical study on lamivudine combined with thymosin α1 in the treatment of chronic hepatitis B. Jilin Medicine 2005, 26: 1059-1060.
20.
go back to reference Zhao WL, Yang ZM, Liu HP, Hui G: Therapeutic Efficacy of Thymosinα1 Combined with Lamivudine on Patients with Chronic Hepatitis B. Practical Clinical Medicine 2007, 8: 7-8. Zhao WL, Yang ZM, Liu HP, Hui G: Therapeutic Efficacy of Thymosinα1 Combined with Lamivudine on Patients with Chronic Hepatitis B. Practical Clinical Medicine 2007, 8: 7-8.
21.
go back to reference Sun JM: The correlation research between the response and resistance rate of lamivudine and thymosin of chronic hepatitis B patients. Chin J Misdiagn 2008, 8: 5351-5352. Sun JM: The correlation research between the response and resistance rate of lamivudine and thymosin of chronic hepatitis B patients. Chin J Misdiagn 2008, 8: 5351-5352.
22.
go back to reference Clarke M, Oxman AD, (editors): Cochrane reviewer's handbook 4.2 in review manager. Oxford, UK: The Cochrane Collaboration; 2004. Clarke M, Oxman AD, (editors): Cochrane reviewer's handbook 4.2 in review manager. Oxford, UK: The Cochrane Collaboration; 2004.
23.
go back to reference Der Simonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2CrossRef Der Simonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2CrossRef
Metadata
Title
Treatment with lamivudine versus lamivudine and thymosin alpha-1 for e antigen-positive chronic hepatitis B patients: a meta-analysis
Authors
Yuan-Yuan Zhang
En-Qiang Chen
Jin Yang
Yu-Rong Duan
Hong Tang
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2009
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/1743-422X-6-63

Other articles of this Issue 1/2009

Virology Journal 1/2009 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine