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대한내과학회> The Korean Journal of Internal Medicine> Platelet count is associated with sustained virological response rates in treatments for chronic hepatitis C

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Platelet count is associated with sustained virological response rates in treatments for chronic hepatitis C

Baek Gyu Jun , Eui Ju Park , Woong Cheul Lee , Jae Young Jang , Soung Won Jeong , Young Don Kim , Gab Jin Cheon , Young Sin Cho , Sae Hwan Lee , Hong Soo Kim , Yun Nah Lee , Sang Gyune Kim , Young Seok Kim , Boo Sung Kim
  • : 대한내과학회
  • : The Korean Journal of Internal Medicine 34권5호
  • : 연속간행물
  • : 2019년 09월
  • : 989-997(9pages)

DOI


목차

INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES

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Background/Aims: This study was conducted to clarify the sustained virological response (SVR) prediction ability of baseline and treatment-related factors in patients with chronic hepatitis C virus (HCV) infection.
Methods: This retrospective study collected data at four tertiary referral hospitals between June 2004 and July 2012. Out of 476 patients, 330 treatment-naïve patients with chronic HCV infection were recruited. Pegylated interferon α-2a/- 2b plus ribavirin was administered for either 24 or 48 weeks depending on the HCV genotype. The baseline and treatment-related predictive factors of SVR were evaluated by analyzing data measured before treatment (i.e., baseline) and during treatment.
Results: SVR rates for genotypes 1 and 2 were 63% (97/154) and 79.5% (140/176), respectively (p = 0.001). Multivariate analysis for baseline factors revealed that young age (p = 0.009), genotype 2 (p = 0.001), HCV RNA level of < 800,000 IU/mL (p < 0.001), and a baseline platelet count of > 150 × 103/μL (p < 0.001) were significant SVR predictors, regardless of the genotype. In particular, predictive accuracy for achievement of SVR was 87.3% for a baseline platelet count of > 150 × 103/μL. In multivariate analysis for treatment-related factors, SVR was associated with achievement of a rapid virological response (RVR; p < 0.001), treatment adherence of ≥ 80/80/80 (p < 0.001).
Conclusions: Young age, genotype 2, low HCV RNA level, RVR, and treatment adherence were significantly associated with SVR. In addition, platelet count was an independent predictive factor for SVR. Therefore, platelet count could be used to develop individualized treatment regimens and to optimize treatment outcomes in patients with chronic HCV infection.

UCI(KEPA)

간행물정보

  • : 의약학분야  > 내과학
  • : KCI등재
  • : SCI
  • : 격월
  • : 1226-3303
  • : 2005-6648
  • : 학술지
  • : 연속간행물
  • : 1986-2019
  • : 2211


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1The epidemiology of hepatitis B virus infection in Korea

저자 : Sun Young Yim , Ji Hoon Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 945-953 (9 pages)

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The global burden of hepatitis B virus (HBV) infection is profound, and represents a public health threat as chronic infection can lead to liver cirrhosis, hepatocellular carcinoma, and death. The risk factors for chronic hepatitis B-related liver disease differ according to HBV endemicity, hepatitis B e-antigen seropositivity, and viral load. It is important to identify these risk factors and start antiviral treatment at an appropriate time according to current guidelines. The most crucial step in reducing HBV infection is prevention in infancy or early childhood, as infection at an early stage may lead to chronicity. South Korea was formerly an HBV-endemic area, but the epidemiology of HBV infection was changed by the introduction of vaccination in 1983 and nationwide immunization in 1995. The government and the private sector made efforts to reduce the prevalence of HBV infection, and Korea is on target to meet the World Health Organization goal of eliminating viral hepatitis by 2030. To eliminate hepatitis worldwide, the costs of antiviral treatment to prevent perinatal HBV transmission in pregnant women with high viremia should be covered by a national program, and strategies to reduce the prevalence of HBV infection in immigrant populations are needed.

2Cellular immunotherapy in multiple myeloma

저자 : Manh-cuong Vo , Thangaraj Jaya Lakshmi , Sung-hoon Jung , Duck Cho , Hye-seong Park , Tan-huy Chu , Hyun-ju Lee , Hyeoung-joon Kim , Sang-ki Kim , Je-jung Lee

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 954-965 (12 pages)

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In multiple myeloma (MM), the impaired function of several types of immune cells favors the tumor's escape from immune surveillance and, therefore, its growth and survival. Tremendous improvements have been made in the treatment of MM over the past decade but cellular immunotherapy using dendritic cells, natural killer cells, and genetically engineered T-cells represent a new therapeutic era. The application of these treatments is growing rapidly, based on their capacity to eradicate MM. In this review, we summarize recent progress in cellular immunotherapy for MM and its future prospects.

3Efficacy and safety of duloxetine in osteoarthritis: a systematic review and meta-analysis

저자 : Mikala C. Osani , Raveendhara R. Bannuru

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 966-976 (11 pages)

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About 21% of adults with osteoarthritis (OA) are diagnosed with concomitant depression in addition to chronic pain. Duloxetine, an anti-depressant medication, has been recently approved for managing Knee OA. We performed a systematic review to ascertain the efficacy and safety of duloxetine for OA. We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Database from inception to December 2018. Randomized clinical trials (RCTs) assessing the efficacy and/or safety of duloxetine versus placebo in OA patients were included. Data extraction and quality assessment were undertaken by two independent reviewers. Seven RCTs (n = 2,102 participants) met our inclusion criteria, and five RCTs (n = 1,713) were eligible for meta-analysis. The results of our analyses indicate that duloxetine has statistically significant, moderate benefits on pain, function, and quality of life in knee OA patients for up to 13 weeks. Reported incidences of gastrointestinal adverse events were three to four times higher in participants who received duloxetine versus placebo. Duloxetine may be an effective treatment option for individuals with knee OA, but use of the drug is associated with a significantly higher risk of adverse events. Patient preferences and clinicians' judgment must be considered before the initiation of duloxetine.

4A paradigm shift in studies based on rheumatoid arthritis clinical registries

저자 : Soo-kyung Cho , Yoon-kyoung Sung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 974-981 (8 pages)

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Clinical research is the study of aspects of patient health or illness that are closely related to clinical practice. In the late 20th and early 21th century, outcomes for patients with rheumatoid arthritis (RA) improved dramatically due to breakthroughs in new drugs. Patient-reported outcome measures now play a significant role in the drug development process as study endpoints in clinical trials of new therapies, and this has led to increased interest in the patient's perspective, drug safety and treatment outcomes in clinical practice. In accordance with these needs, many prospective cohorts for RA patients and registries of biologic disease modifying anti-rheumatic drugs have been actively conducted in the United States and European and Asian countries. A gradual shift is taking place in the major outcomes of clinical research using these prospective cohorts and registries. This article will introduce representative registries for RA in each country set up in the early 2000s and will discuss future perspectives in clinical research on RA patients using such clinical registries.

5Female hormones and the risk of colorectal neoplasm

저자 : Yunho Jung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 982-984 (3 pages)

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6Recommended and real-world treatment of knee osteoarthritis in Korea: differences and compromises

저자 : Hyun-sook Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 985-988 (4 pages)

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7Platelet count is associated with sustained virological response rates in treatments for chronic hepatitis C

저자 : Baek Gyu Jun , Eui Ju Park , Woong Cheul Lee , Jae Young Jang , Soung Won Jeong , Young Don Kim , Gab Jin Cheon , Young Sin Cho , Sae Hwan Lee , Hong Soo Kim , Yun Nah Lee , Sang Gyune Kim , Young Seok Kim

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 989-997 (9 pages)

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Background/Aims: This study was conducted to clarify the sustained virological response (SVR) prediction ability of baseline and treatment-related factors in patients with chronic hepatitis C virus (HCV) infection.
Methods: This retrospective study collected data at four tertiary referral hospitals between June 2004 and July 2012. Out of 476 patients, 330 treatment-naïve patients with chronic HCV infection were recruited. Pegylated interferon α-2a/- 2b plus ribavirin was administered for either 24 or 48 weeks depending on the HCV genotype. The baseline and treatment-related predictive factors of SVR were evaluated by analyzing data measured before treatment (i.e., baseline) and during treatment.
Results: SVR rates for genotypes 1 and 2 were 63% (97/154) and 79.5% (140/176), respectively (p = 0.001). Multivariate analysis for baseline factors revealed that young age (p = 0.009), genotype 2 (p = 0.001), HCV RNA level of < 800,000 IU/mL (p < 0.001), and a baseline platelet count of > 150 × 103/μL (p < 0.001) were significant SVR predictors, regardless of the genotype. In particular, predictive accuracy for achievement of SVR was 87.3% for a baseline platelet count of > 150 × 103/μL. In multivariate analysis for treatment-related factors, SVR was associated with achievement of a rapid virological response (RVR; p < 0.001), treatment adherence of ≥ 80/80/80 (p < 0.001).
Conclusions: Young age, genotype 2, low HCV RNA level, RVR, and treatment adherence were significantly associated with SVR. In addition, platelet count was an independent predictive factor for SVR. Therefore, platelet count could be used to develop individualized treatment regimens and to optimize treatment outcomes in patients with chronic HCV infection.

8Age at menarche and risk of colorectal adenoma

저자 : Nam Hee Kim , Jung Ho Park , Dong Il Park , Chong Il Sohn , Kyuyong Choi , Yoon Suk Jung

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 998-1007 (10 pages)

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Background/Aims: Limited data are available regarding the association between age at menarche and the risk of colorectal adenoma. Therefore, we aimed to evaluate the relationship between reproductive factors including age at menarche and the risk of colorectal adenoma.
Methods: A cross-sectional study was performed on asymptomatic female subjects who underwent colonoscopy between 2010 and 2014 as part of a comprehensive health screening program in Korea. The association between reproductive factors including age at menarche and the presence of adenomas was assessed using multivariate logistic regression analysis.
Results: Among 32,620 asymptomatic female subjects, the proportion of patients with menarche at 10 to 11, 12 to 13, 14 to 15, 16 to 17, and 18 to 19 years of age was 4.1%, 31.7%, 45.4%, 14.9%, and 4.0%, respectively. Age at menarche was not significantly associated with the risk of any adenoma (adjusted odds ratio [AOR], 0.99; 95% confidence interval [CI], 0.97 to 1.02; p = 0.500) or advanced adenoma (AOR, 0.98; 95% CI, 0.91 to 1.04; p = 0.468) after adjusting for confounding factors. Age at menarche was not significantly associated with the risk of adenoma even among similar age groups. In addition, parity, use of female hormones, and menopause were not associated with the risk of adenoma.
Conclusions: Age at menarche, parity, use of female hormones, and menopause were not significantly associated with the risk of colorectal adenoma. Our findings indicate that reproductive factors including age at menarche do not affect the development of colorectal adenoma.

9The efficacy and safety of irsogladine maleate in nonsteroidal anti-inflammatory drug or aspirin-induced peptic ulcer and gastritis

저자 : Ki-nam Shim , Jin Il Kim , Nayoung Kim , Sang Gyun Kim , Yun Ju Jo , Su Jin Hong , Jeong Eun Shin , Gwang Ha Kim , Kyung Sik Park , Suck Chei Choi , Joong Goo Kwon , Jie-hyun Kim , Hyun Jin Kim , Ji Won

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 1008-1023 (16 pages)

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Background/Aims: Irsogladine maleate, an enhancer of gastric mucosal protective factors, has demonstrated its efficacy for various gastric mucosal injuries. The aim of this study was to evaluate the efficacy and safety of irsogladine for prevention of nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin-induced peptic ulcer and gastritis.
Methods: In this multicenter, randomized, double-blind, exploratory clinical trial, 100 patients over 50 years of age who needed continuous NSAIDs or aspirin for more than 8 weeks were randomly assigned to either test group (irsogladine maleate 2 mg, twice daily, 39 patients for full analysis) or placebo group (37 patients for full analysis). Primary outcomes were incidence of peptic ulcer and ratio of modified Lanza score (MLS) 2 to 4. Secondary outcome was the number of acute erosions confirmed by endoscopy at 8 weeks. Adverse effects were also compared.
Results: There were no significant differences in gastric protective effects between test and placebo groups. However, two cases of peptic ulcer in the placebo group but none in the test group were observed. These two cases of peptic ulcer were Helicobacter pylori-negative. In addition, H. pylori-negative group showed significant changes in MLS score (p = 0.0247) and edema score (p = 0.0154) after the treatment compared to those before treatment in the test group. There was no significant difference in adverse events between the two groups.
Conclusions: The efficacy of irsogladine maleate was found in H. pylori-negative group, suggesting its potential as a protective agent against NSAIDs or aspirin-induced peptic ulcer and gastritis.

10Clarithromycin resistance and female gender affect Helicobacter pylori eradication failure in chronic gastritis

저자 : Young Woon Chang , Weon Jin Ko , Chi Hyuk Oh , Yoo Min Park , Shin Ju Oh , Jung Rock Moon , Jun-hyung Cho , Jung-wook Kim , Jae-young Jang

발행기관 : 대한내과학회 간행물 : The Korean Journal of Internal Medicine 34권 5호 발행 연도 : 2019 페이지 : pp. 1022-1029 (8 pages)

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Background/Aims: The eradication rate of the first-line triple therapy (a proton pump inhibitor, clarithromycin, and amoxicillin) for Helicobacter pylori infection has gradually decreased in Korea. We evaluated whether clinical parameters, clarithromycin resistance, and CYP2C19 genotype can affect the eradication failure.
Methods: A total of 203 patients with H. pylori-positive chronic gastritis were consecutively enrolled. They received clarithromycin-based triple therapy for 7 days. A clarithromycin resistance test was performed by detection of A2142G and A2143G point mutations in H. pylori 23S rRNA. The CYP2C19 genotype was examined for polymorphism G681A of exon 5 and G636A of exon 4 by polymerase chain reaction with restriction fragment length polymorphism. Eradication was assessed by a 13C-urea breath test 4 weeks after treatment.
Results: Of 203 patients, 190 completed the study. The eradication rate was 64.0% according to intention-to-treat analysis and 68.4% by per-protocol analysis. CYP2C19 genotypes were identified as follows: 75 poor metabolizers, 75 intermediate metabolizers, and 40 rapid metabolizers. Nonetheless, this polymorphism was not significantly associated with eradication failure (p = 0.682). Clarithromycin resistance was detected in 33/190 patients (17.4%), and their eradication rate was zero. Clarithromycin resistance (odds ratio [OR], 19.13; 95% confidence interval [CI], 9.35 to 35.09) and female gender (OR, 1.73; 95% CI, 1.15 to 4.25) were significantly associated with eradication failure. The other clinical parameters such as age, cigarette smoking, alcohol intake, the body mass index, hypertension, and diabetes were not significantly associated with eradication.
Conclusions: Clarithromycin resistance and female gender are factors affecting H. pylori eradication failure in patients with chronic gastritis.

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