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2016, Number 4

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Ann Hepatol 2016; 15 (4)

Meta-analysis of the clinical value of oxymatrine on sustained virological response in chronic hepatitis B

He M, Wu Y, Wang M, Chen W, Jiang J

Language: English
References: 27
Page: 482-491
PDF size: 175.64 Kb.


ABSTRACT

Introduction. Oxymatrine (OMTR) is widely used for the treatment of chronic hepatitis B (CHB) in China. Several recent reports revealed that OMTR together with interferon yielded a higher sustained virological response (SVR) than interferon alone. Aim. To elucidate this topic using meta-analysis of data from published randomized controlled trials (RCTs). Material and methods. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, China National Knowledge Infrastructure, Wanfang Database and China Biomedical Database were searched to identify RCTs that evaluated SVR to interferon therapies and interferon plus OMTR therapies in CHB patients. Results. The literature search yielded 238 studies, and 11 RCTs comprising 968 patients matched the selection criteria. Overall, SVR was significantly higher in patients treated with interferon plus OMTR than in patients treated with interferon alone (SVR: 60.7 vs. 39.8%; relative risk: 1.56; 95% confidence interval: 1.37-1.77; p ‹ 0.05). Combined therapy of interferon plus OMTR were also superior to interferon therapies alone in achieving the endof- treatment viral response, alaninetransaminase normalization, HBeAg loss, and HBeAg seroconversion. Conclusions. Combined therapy of interferon plus OMTR may yield a higher SVR than interferon therapies. The exact outcome needs to perform rigorously designed, multicenter, and large randomized controlled trials.


REFERENCES

  1. European Association for the Study of the Liver. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167-85 [PubMed: 22436845].

  2. Liaw YF. Antiviral therapy of chronic hepatitis B: Opportunities and challenges in Asia. J Hepatol 2009; 51: 403-10 [PubMed: 19467727].

  3. Sun J, Hou JL. Management of chronic hepatitis B: experience from China. J Viral Hepat 2010; 17: 10-7 [PubMed: 20586929].

  4. Lu LG, Zeng MD, Mao YM, Fang JY, Song YL, Shen ZH, Cao AP. Inhibitory effect of oxymatrine on serum hepatitis B virus DNA in HBV transgenic mice. World J Gastroenterol 2004; 10: 1176-9 [PubMed: 15069721].

  5. Xu WS, Zhao KK, Miao XH, Ni W, Cai X, Zhang RQ, Wang JX. Effect of oxymatrine on the replication cycle of hepatitis B virus in vitro. World J Gastroenterol 2010; 16: 2028-37 [PubMed: 20419842].

  6. Lu LG, Zeng MD, Mao YM, Li JQ, Wan MB, Li CZ, Chen CW, et al. Oxymatrine therapy for chronic hepatitis B: a randomized double-blind and placebo-controlled multicenter trial. World J Gastroenterol 2003; 9: 2480-3 [PubMed: 14606080].

  7. Mao YM, Zeng MD, Lu LG, Wan MB, Li CZ, Chen CW, Fu QC, et al. Capsule oxymatrine in treatment of hepatic fibrosis due to chronic viral hepatitis: a randomized, double blind, placebo- controlled, multicenter clinical study. World J Gastroenterol 2004; 10: 3269-73 [PubMed: 15484298].

  8. Jin XH, Wang YG. Cost effectiveness analysis of three methods in the treatment of chronic viral hepatitis B. Strait Pharmaceutical J 2008; 20: 139-40. Available at: http:// epub.cnki.net/kns/brief/result.aspx?dbPrefix=CJFQ

  9. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17: 1-12 [PubMed: 8721797].

  10. Huang YQ, Lin ZH, Ji SM, Xu ZJ, Wang CG. Clinical study of the interferon α-2b combined with oxymatrine in the treatment of chronic hepatitis B. Chin J Infect Dis 2004; 22: 259- 262. Available at: Available at: http://epub.cnki.net/kns/brief/ result.aspx?dbPrefix=CJFQ

  11. Li WH. Clinical study of Interferon-a combined with oxymatrine in the treatment of patients with HbeAg- positive hepatitis B. J Prac Hepatol 2014; 17: 186-7. Available at: http://epub.cnki.net/kns/brief/result.aspx?dbPrefix=CJFQ

  12. NuEGL YBLYM. Clinical study of the interferon combined with oxymatrine in the treatment of chronic hepatitis B. Chinese Community Doctors 2011; 13: 214. Available at: http:// epub.cnki.net/kns/brief/result.aspx?dbPrefix=CJFQ

  13. OuYang GS. Clinical study of Interferon combined with oxymatrine in the treatment of patients with HbeAg- positive hepatitis B. National Medical Frontiers of China 2011; 6: 17-8. Available at: http://epub.cnki.net/kns/brief/result.aspx? dbPrefix= CJFQ

  14. Qin ZX, Zhang GC, Wang L, Zhu SF. Kushenin in combination with α-2b interferon for chronic hepatitis B: Observation of prospective efficacy. J Chinese Physician 2006; 18: 858-9. Available at: http://epub.cnki.net/kns/brief/result.aspx?dbPrefix=CJFQ

  15. Shi YZ, Li CX. Clinical study of the interferon combined with oxymatrine in the treatment of chronic hepatitis B. Clinical Medicine of China 2004; 20: 417-8. Available at: http:// epub.cnki.net/kns/brief/result.aspx?dbPrefix=CJFQ

  16. Shi ZJ, Zhang HT, Zhang XY. Kushenin in Combination with α-2b Interferon for chronic hepatitis B: Observation of Curative Efficacy. China Pharmacy 2007; 18: 2139-40. Available at: http://epub.cnki.net/kns/brief/result.aspx? dbPrefix =CJFQ

  17. Wen XM. Clinical study of the interferon α-2b combined with oxymatrine in the treatment of chronic hepatitis B. Secondary Medical Education 2003; 21: 136-7. Available at: http:// epub. cnki .net/ kns/brief/ result.aspx?dbPrefix =CJFQ

  18. Yu JG. Clinical study of the interferon a-2a combined with oxymatrine in the treatment of chronic hepatitis B. Chinese Hepatology 2013; 18: 205-6. Available at: http://epub.cnki. net/kns/brief/result.aspx?dbPrefix=CJFQ

  19. Zhang XD, Sun MZ, Li XF, Liu ZJ. Observation of the therapeutic effects of interferon combined with Kushenin in the treatment of chronic hepatitis B. China Pharmacy 2005; 16: 450-1. Available at: http://epub.cnki.net/kns/brief/result.aspx ?dbPrefix=CJFQ

  20. Zhao WL, Hu QM, Yang ZM, Zhang W. Clinical study of Interferon- α combined with oxymatrine in the treatment of patients with chronic hepatitis B. Journal of Yangtze University (Natural Science Edition) Medicine V 2007; 4: 161-2. Available at: http://epub.cnki.net/kns/brief/result.aspx?dbPrefix=C JFQ

  21. Cui X, Wang Y, Kokudo N, Fang D, Tang W. Traditional Chinese medicine and related active compounds against hepatitis B virus infection. Biosci Trends 2010; 4: 39-47 [PubMed: 20448340].

  22. Wang YP, Liu F, He HW, Han YX, Peng ZG, Li BW, You XF, et al. Heat stress cognate 70 host protein as a potential drug target against drug resistance in hepatitis B virus. Antimicrob Agents Chemother 2010; 54: 2070-7 [PubMed: 20176893].

  23. Wang YP, Zhao W, Xue R, Zhou ZX, Liu F, Han YX, Ren G, et al. Oxymatrine inhibits hepatitis B infection with an advantage of overcoming drug-resistance. Antiviral Res 2011; 89: 227-31 [PubMed: 21277330].

  24. Yao N, Wang X. In vitro immunomodulatory activity of oxymatrine on toll-like receptor 9 signal pathway in chronic hepatitis B. Am J Chin Med 2014; 42: 1399-410 [PubMed: 25406654].

  25. Chai NL, Fu Q, Shi H, Cai CH, Wan J, Xu SP, Wu BY. Oxymatrine liposome attenuates hepatic fibrosis via targeting hepatic stellate cells. World J Gastroenterol 2012; 18: 4199-206 [PubMed: 22919254].

  26. Dong YH, Xi HL, Tian F, Kang AJ, Zhang NL, Yu M, Yu YY, et al. Effects of oxymatrine on serum levels of Th1/Th2 type cytokines in HBsAg transgenic mice. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi 2004; 18: 277-80 [PubMed: 15640867].

  27. Gu XB, Yang XJ, Hua Z, Lu ZH, Zhang B, Zhu YF, Wu HY, et al. Effect of oxymatrine on specific cytotoxic T lymphocyte surface programmed death receptor-1 expression in patients with chronic hepatitis B. Chin Med J (Engl) 2012; 125: 1434-8 [PubMed: 22613649].




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