Effect of Shifting from Combination Therapy to Monotherapy of α-Blockers or 5α-Reductase Inhibitors on Prostate Volume and Symptoms in Patients with Benign Prostatic Hyperplasia

김형우,문두건,김현민,황종호,김순찬,남삼극,박준탁 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.10

Purpose: Combination therapy of a-blockers and 5α-reductase inhibitors (5-ARIs) is widely used for the treatment of benign prostatic hyperplasia (BPH). We aimed to study the effect on prostate volume and symptoms of shifting to monotherapy in patients who previously received a combination therapy. Materials and Methods: A prospective study was conducted of 60 patients who were diagnosed with BPH. Patients were aged 45 years or older and had a prostate volume of 30 cc or more, International Prostate Symptom Score (IPSS) of 12 or above, maximal flow rate (Qmax) of 15 ml/s or less, and prostate-specific antigen (PSA) level of less than 10 ng/ml. The patients initially received a combination therapy of doxazosin 4 mg/day and finasteride 5 mg/day for 3 months and were then randomly assigned to receive monotherapy for 3 months. The factors were then compared. Results: A total of 30 patients were assigned to doxazosin (group 1) and 30 to finasteride (group 2) after the combination therapy. The percentage changes in prostate volume, IPSS, and Qmax during the period from post-combination therapy to post-monotherapy were not significantly different between the two groups (p=0.052, 0.908, 0.081), whereas PSA significantly decreased in group 2 (p<0.001). IPSS was not significantly different at post-combination therapy and at post-monotherapy in both groups (p=0.858, 0.071). The prostate volume significantly increased from 40.97 cc at post-combination therapy to 44.29 cc at post-monotherapy in group 1 (p=0.001) and insignificantly increased from 38.32 cc to 38.61 cc in group 2 (p=0.696). Conclusions: Although the duration of drug administration was short in this study, 5-ARI monotherapy could maintain the alleviated symptoms and reduce the risk of acute urinary retention and surgery due to prostate regrowth in BPH patients whose symptoms improved with combination therapy.

양성갑상선종물 환자에서 갑사선 호르몬 억제요법과 갑상선 호르몬과 항갑상선제 병합요법의 치료효과 비교

최성남,공병호,배현철,오연상,신순현 중앙대학교 의과대학 의과학연구소 1998 中央醫大誌 Vol.23 No.1

Traditionally, patients with nontoxic benign thyroid nodule has been treated with levothyroxine. The successful treatment of T4 suppressive therapy, however, has been observed in 50 % of patients with thyroid nodules oven though the treatment were continued more than 1 year. The side effects such as osteoporosis, left ventricular hypertrophy has been observed. Therefore, we performed this study to evaluate the efficacy of the new treatment modality (levothyroxine and methimazole combination) in the treatment of thyroid nodule. Study population was 67 patients having nontoxic benign thyroid nodule. Serum TSH, fT4, T3 and thyroid nodular volume were measured at pretreatment and post-treatment periods. The benign thyroid lesion was confirmed by FNAC (fine needle aspiration cytology). The factors can be influenced on therapeutic response were also studied. The patients were divided into two groups. One group had been treated with levothyroxine only and the other with levothyroxine and anthithyroid drug combination. 47 patients had been treated with levothyroxine only. The other 20 patients had received combination therapy with levothyroxine and methimazole. The mean age and sex ratio, pretreatment nodular volume, TSH, fT4 and total T3 level measured at pretreatment and post-treatment had no stastistical difference between two groups. The combination therapy group had been treated for 8.4 ± 2.6 months and T4 suppressive therapy group for 11.1 ± 4.8 months (P=0.03). Pretreatment TSH concentration was 0.99 ± 0.60 μIU/ml in T4 suppressive therapy group, 1.43 ± 1.21 μIU/ml in combination therapy group. (P=0.023) But the value of serum TSH in both groups was in normal range. The responder group was 17 patients and the response rate was 85 % in combination therapy group and 25 and 53 % in T4 suppressive group. In the combination therapy group, the volume reduction was more greater. (71.5% in combination group, 18.1 % in T4 group) In conclusion, combination therapy can reduce treatment duration, enhance therapeutic response rate for the treatment of benign thyroid nodule. The exact mechanism of methimazole on thyroid nodule wan not not clearly known. Perhapse, the influence of methimazole on the transcription factor may be involved Further study in this regard is needed in the future.

P067 A retrospective analysis of low dose acitretin and cyclosporine combination therapy in psoriasis patients

( In-hye Kang ),( Hye-jin Ahn ),( Eun-jae Shin ),( Min Jae Gwak ),( Min Kyung Shin ),( Nack-in Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.2

<div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div><div style="display:none">fiogf49gjkf0d</div> Background: Psoriasis is a chronic in.ammatory disorder. Approximately 25% of patients present with a moderate-to-severe form of psoriasis and may require lifelong systemic therapy. Up until recently, there have been few reports showing the effectiveness and safety of adding cyclosporine to acitretin for treatment. Objectives: The aim of our study was to gain more knowledge about systemic combination therapies with retinoids and cyclosporine. Methods: Retrospective review of the databases of dermatological departments at Kyung Hee Medical Center was performed. 11 patients treated with oral acitretin and cyclosporine combination therapy, 12 and 14 patients treated with acitretin and cyclosporine monotherapy, respectively were included in the study. The data including age, gender, comorbidity, treatment regimen, period, presence of adverse events, and the PASI score were collected. Results: There were no significant differences in the degree of reduction of PASI scores after 12 weeks among the three groups. The number of patients with adverse events was 19 in the acitretin monotherapy group, 10 in the cyclosporine monotherapy group, and 9 in the combination treatment group. Conclusion: Although low dose combination therapy of acitretin and cyclosporine has similar effects compared to the monotherapy, side effects was lower in combination therapy because of drug sparing effects. We suggest combination therapy employing systemic agents are becoming more widely used for the treatment of psoriasis.

교통사고(交通事故) 환자(患者)의 한방치료(韓方治療)와 한양방협진치료(韓洋方協診治療) 비교(比較) 연구(硏究)

이경희,김정은,윤현민,고우신,송춘호,장경전,안창범,김철홍,Lee, Kyoung-Hee,Kim, Jung-Eun,Youn, Hyoun-Min,Ko, Woo-Shin,Song, Choon-Ho,Jang, Kyung-Jeon,Ahn, Chang-Beohm,Kim, Cheol-Hong 대한약침학회 2007 Journal of pharmacopuncture Vol.10 No.3

Objective The purpose of this study is to investigate the difference of treatment effect between Oriental Medicine therapy and Oriental and Western Medicine combination therapy on traffic accident patients. Methods Sixty one traffic accident patients were randomly assigned to the Oriental Medicine therapy group(group I)and Oriental and Western Medicine combination therapy group(group II). Evaluations were made before treatment, after one week treatment and after two weeks treatment using Visual Analog Scale(VAS), Oswestry disability Index(ODI), Neck Disability Index(NDI), Roland Morris Disability Scale(RMDS). The obtained data were analyzed and compared. Results The group I showed significant improvement(p<0.05) according to the VAS, NDI. But that showed insignificant improvement according to the ODI, RMDS. The group II showed significant improvement(p<0.05) according to the VAS, NDI. But that showed insignificant improvement according to the ODI, RMDS. And the difference between the two groups were insignificant according to VAS, NDI, ODI and RMDS. Conclusion There is no significant difference between the two groups after each therapy on traffic accident patients. Further studies are needed for the comparison of the Oriental Medicine therapy and Western Medicine combination therapy.

고령의 비소세포성폐암 환자의 방사선 및 병용치료에 대한 효과 평가

윤원섭(Won-Sup Yoon),양대식(Dae-Sik Yang),김철용(Chul-Yong Kim) 대한방사선종양학회 2007 Radiation Oncology Journal Vol.25 No.2

목 적: 70세 이상 고령의 비소세포성폐암 환자에서 단독방사선치료 및 화학방사선병행요법에 대한 독성과 생존율 을 비교하였다. 대상 및 방법: 1998년에서 2002년까지 만 70세 이상의 Ⅲ기 비소세포성폐암으로 방사선치료를 시행한 57명에 대해 후향적 분석을 시행하였다. 중앙추적조사기간은 9개월(1∼53.4개월)이었다. 단독방사선치료(갑군)를 시행한 환자가 33명, 동시화학방사선치료(을군)를 시행한 환자가 16명, 화학요법 후 방사선치료(병군)를 시행한 환자가 8명 이었다. 남자, 여자가 각각 51, 6명, 중앙연령은 74 (70∼85)세였다. Ⅲa와 Ⅲb기가 각각 23, 34명이었다. 갑군과 을군의 비교 시 종양의 크기가 갑군이 더 큰 것 외에는 의미 있는 분포의 차이는 없었다. 방사선치료의 분할선량은 동시화학방사선치료 시에는 1.8 Gy로, 그 외의 경우는 방사선치료범위를 고려하여 1.8∼3 Gy로 하였고 분할선량에 따라 51∼63 Gy를 조사하고자 하였다. 계획된 방사선량을 모두 조사받은 경우를 완전종결로 하였고 그렇지 못한 경우를 불완전종결로 하였다. 결 과: 57명 중 52명의 환자가 추적조사기간 중 사망하였다. 갑, 을, 병군에서 완전종결 환자는 28, 10, 7명이었고 앙방사선치료기간은 각각 35, 60.5, 35일이었다. 전체 환자의 중앙생존기간은 10.1개월이었고 1년, 2년 생존율은 39.8, 17.6%였다. 갑, 을, 병군의 중앙생존기간은 각각 8.9, 8.2, 11.7개월이었고 1년 생존율은 38.4, 37.5, 50%였다. 방사선치료가 불완전 종결된 갑, 을, 병군은 각각 5, 6, 1명으로 N병기(N3)(p=0.081), 치료방법의 차이(p=0.079)가 불완전 종결에 영향을 줄 가능성이 높았다. 을군에서 병용 화학요법제를 시행한 8명 중 4명은 부작용으로 치료를 중단하였다. 예후인자의 평가에서 T병기(T3 이상), 종양의 크기(5 cm 이상), KPS (70 이하), 불완전 종결이 단일변량분석과 다변량분석에서 유의하였다. 론: 고령의 비소세포성폐암 환자에서 단독방사선치료는 타 치료와 비교 시 대등한 생존기간을 나타냈으며 동시 화학방사선치료에 비해 부작용으로 치료를 중단하는 경우가 적어 대체로 고령의 환자가 치료에 잘 견디는 치료였 다. 고령의 환자에서 동시화학방사선치료를 고려할 시에는 치료의 견딤 정도를 고려하여 환자의 선택 및 약제의 선 택에 주의하여야 할 것이다. Purpose: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients (70=or≥) with non-small-cell lung cancer (NSCLC). Materials and Methods: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range 70∼85). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and 1.8∼3 Gy in other groups. Total radiation dose was 51∼63 Gy according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. Results: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage (T≥3), mass size (≥5 cm), Karnofsky performance scale (≤70) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. Conclusion: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.

라미부딘과 아데포비어에 순차 내성을 보인 만성 B형 간염 환자에서 라미부딘/아데포비어 병합요법의 항바이러스 효과

서현주 ( Hyun Joo Suh ),박문경 ( Moon Kyung Park ),이향이 ( Hyang Ie Lee ),곽금연 ( Geum Yeon Gwak ),고광철 ( Kwang Cheol Koh ),백승운 ( Seung Woon Paik ),유병철 ( Byung Chul Yoo ),이준혁 ( Joon Hyeok Lee ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.5

목적: LMV과 ADV의 단독치료에 순차내성을 보인 만성 B형 간염 환자에서 LMV과 ADV의 병합투여 후 항바이러스 효과를 알아보고자 하였다. 대상 및 방법: 1997년부터 2007년 사이 LMV와 ADV에 순차적으로 바이러스 돌파현상을 보였던 만성 B형 간염 환자들을 대상으로 하였고, 이들 중 LMV과 ADV 병합치료를 받은 18명의 환자들을 후향 분석하였다. 결과: LMV-ADV 병합치료 시행 후 추적관찰 기간의 중앙값은 17개월(범위, 6-27)이었다. 병합치료 0, 3, 6, 12, 24개월의 평균 DNA역가는 6.08±0.95, 4.05±1.66, 3.17±1.58, 3.18±2.16, 2.35±1.52 log10 IU/mL였고 전체 18예 중 16예(88.9%)에서 HBV DNA의 역가가 20,000 IU/mL 미만으로 감소하였다. HBeAg의 혈청전환은 단 1예(7.1%)에서만 관찰되었고 12예(66.7%)에서 혈청 ALT가 정상화되었다. 병합치료 12개월과 14개월째 바이러스 반등이 있었던 환자가 2예 있었다. 혈청 ALT는 12예(66.7%)에서 정상으로 감소하였다. 일차치료 실패를 보인 경우는 2예(11.1%)가 있었다. 결론: 이번 연구에서 LMV과 ADV에 순차적으로 내성을 보인 환자들에게 LMV-ADV 병합치료를 시행하고 단기간 추적관찰하였을 때 88.9%에서 효과가 있었다. 이는 다른 항바이러스제의 사용이 여의치 않을 때 LMV-ADV의 병합치료가 도움이 될 수 있음을 보여준다. Background/Aims: The aim of this study was to elucidate the antiviral efficacy of lamivudine (LMV)-adefovir (ADV) combination therapy in chronic hepatitis B patients who showed resistance to LMV and ADV consecutively. Methods: A retrospective review was performed in eighteen patients with chronic hepatitis B who developed virologic breakthroughs during LMV-ADV sequential mono-therapy and treated with LMV-ADV combination therapy. Results: The median duration of follow up was 17 months (range, 6-27) after the start of LMV-ADV combination therapy. Mean HBV DNA level in log10 IU/mL was 6.08±0.95, 4.05±1.66, 3.17±1.58, 3.18±2.16, and 2.35±1.52 at 0, 3, 6, 12, and 24 months, respectively. Sixteen patients (88.9%) showed HBV DNA reduction below detection limit (<20,000 IU/mL). HBeAg seroconversion was observed in one patient (7.1%) after 8 months of combination therapy. Virologic breakthrough occurred in only one patient after 21 months of combination therapy. Viral rebound occurred in two patients at 12 months and 14 months of combination therapy. Normalization of serum ALT was achieved in twelve patients (66.7%). Primary non-response was observed in two cases (11.1%). Conclusions: LMV-ADV combination treatment was effective in 88.9% of patients with resistance to LMV and ADV in a short-term follow up. It may be applied as a bridge therapy until another effective antiviral regimen becomes available. (Korean J Gastroenterol 2009;53:305-310)

만성 C형간염 환자에서 인터페론 알파와 리바비린 병합요법의 치료 효과와 합병증

황상연 ( Sang Youn Hwang ),이혜정 ( Hae Jung Lee ),박기태 ( Kee Tae Park ),김경엽 ( Kyung Yup Kim ),이선미 ( Sun Mi Lee ),박찬원 ( Chan Won Park ),김태오 ( Tae Oh Kim ),김광하 ( Gwang Ha Kim ),허정 ( Jeong Heo ),강대환 ( Dae Hwan 대한소화기학회 2007 대한소화기학회지 Vol.49 No.3

목적: 만성 C형간염 환자의 인터페론 혹은 페그인터페론과 리바비린 병합요법의 치료 효과는 잘 알려져 있다. 그러나 치료에 따른 합병증을 중점으로 다룬 연구는 많지 않다. 이번 연구는 다양한 범주의 만성 C형간염 환자를 대상으로 인터페론과 리바비린 병합요법의 효용성과 합병증을 연구하고자 하였다. 대상 및 방법: 2001년 1월부터 2005년 1월까지 부산대학교병원에서 인터페론과 리바비린을 투여 받은 240명의 만성 C형간염 환자를 대상으로 치료 합병증을 평가하였고, 그중 치료를 종결한 154명의 환자를 대상으로 이들의 치료종결반응(end of treatment resoponse, ETR)과 지속바이러스반응(sustained virologic response, SVR)을 후향으로 평가하였다. 투여기간은 유전자 1형은 12개월, 비 1형은 6개월로 하였고, 인터페론 알파 300만 단위를 주 3회 피하주사로, 리바비린 800-1,200 mg을 매일 경구로 투여하였다. 결과: 총 240명의 환자의 남녀비는 143:97였고, 유전자 1형은 111명, 비 1형은 106명, 검사하지 않았거나 분석할 수 없었던 경우가 23명이었다. 치료를 완료한 154명의 ETR, SVR은 각각 79.2%, 61.0%였고, ETR을 보인 환자 중 SVR에 관한 추적관찰을 하지 못한 13명을 제외하였을 때 SVR은 66.7%였다. 치료를 조기에 중단한 환자는 35.8%로 순수 치료 부작용으로 인한 경우가 15.4%, 추적방문 실패로 인한 경우가 7.9%, 치료 경과 중 바이러스 음전실패 및 돌파현상으로 인한 경우가 11.3%, 그 외 원발 복막염, 간세포암종, 심근경색의 경우가 1.2%였다. 부작용으로 치료를 중단했던 경우는 간기능 악화가 8명, 우울증과 관련된 증상이 10명 (식욕부진 5명, 무력감 및 피곤함 2명, 자살충동 2명, 불면증 1명), 체질증상이 7명, 탈모 4명, 피부발진 2명, 혈소판 감소 2명, 그 외 피부 소양증, 설사, 흉통, 체중 감소가 각각 1명이었다. 빈혈로 인해 리바비린을 감량한 경우는 37명(15.4%), 백혈구 감소와 혈소판 감소로 인터페론을 감량한 경우는 각각 21명(8.8%)과 11명(4.6%)이었다. 결론: 치료를 완료한 환자들의 SVR은 61.0%였고, 환자의 약 3분의 1이 치료반응 부족, 부작용 및 순응도 부족으로 치료를 조기 중단하였다. Background/Aims: The effectiveness of combination therapy with conventional or pegylated interferon alpha and ribavirin in patients with chronic hepatitis C is well understood. However, the profound investigation about complications of the treatment has been rarely reported in Korea, where patients have broader spectrum of disease manifestations. The aim of this study was to evaluate the effectiveness and complications of the combination therapy of interferon alpha and ribavirin in patients with chronic hepatitis C. Methods: Two hundred and forty patients with chronic hepatitis C were included. All patients were treated with interferon alpha (3 million units thrice a week) in combination with ribavirin (800-1,200 mg, depending on body weight). Patients were treated for 6 or 12 months according to the genotypes (genotype 1; 12 months, non-1; 6 months). We retrospectively evaluated ETR (end of treatment response) and SVR (sustained virologic response) on the basis of intent-to-treat in patients completing the therapy. Results: In 154 patients who had completed the therapy, ETR was 79.2% and SVR was 61.0%. Multivariate analysis showed that genotype and early virologic response at 3 months of treatment were indepedent predictive factors of SVR. Due to insufficient response, 11.3% of the patients discontinued the therapy. In addition, 24.5% of the patients prematurely discontinued the therapy due to adverse events including aggravated liver function (15.4%), failure to return (7.9%), and others (1.2%). Dose modifications of interferon alpha or ribavirin were required due to anemia (15.4%), neutropenia (8.8%), or thrombocytopenia (4.6%). Conclusions: The overall SVR of patients who had completed the combination therapy with interferon alpha and ribavirin was 61.0%. However, about one third of the patients discontinued the therapy prematurely due to insufficient response, adverse events and/or noncompliance. (Korean J Gastroenterol 2007;49:166-172)

HBV : O-005 ; Is an adefovir plus entecavir combination therapy superior to adefovir plus lamivudine combination therapy in patients with chronic hepatitis B resistant to both lamivudine and adefovir?

( Yuri Cho ),( Dong Hyeon Lee ),( Kwang Hyun Chung ),( Jeong Hoon Lee ),( Eun Ju Cho ),( Eun Sun Jang ),( Min Sun Kwak ),( Su Jong Yu ),( Jin Wook Kim ),( Sook Hyang Jeong ),( Jung Hwan Yoon ),( Hyo S 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1

Background: The efficacy of adefovir (ADV) plus entecavir (ETV) combination in patients with chronic hepatitis B (CHB) who developed multidrug resistance had not been fully evaluated. We aimed to evaluate the efficacy of ADV plus ETV as compared to that of LAM plus ADV in patients with antiviral resistance to both LAM and ADV. Methods: 27 patients were treated with a combination of ADV plus ETV and 63 patients were treated with a combination of LAM plus ADV. The virological and biochemical parameters were compared between the two groups. Results: Treatment with a combination of ADV plus ETV produced a significantly superior in virological response compared to that in the LAM plus ADV group during 12 months of therapy. At 12 months, the HBV DNA declined more in the ADV plus ETV than in the LAM plus ADV (-4.52 ± 1.956 vs. -2.65 ± 1.723 log10IU/mL; p = 0.001). The rate of a complete response at 12 months was greater in the ADV plus ETV than that in the LAM plus ADV (73.68% vs. 31.48%, p = 0.005). Conclusions: In patients with CHB resistant to both LAM and ADV, the response to ADV plus ETV was significantly superior compared to that of the LAM plus ADV for suppressing HBV DNA through 12 months. The result indicates that ADV plus ETV rather than LAM plus ADV might be used as a bridging therapy in patients with CHB resistant to both LAM and ADV, especially in areas where tenofovir is not available.

HBV : O-005 ; Is an adefovir plus entecavir combination therapy superior to adefovir plus lamivudine combination therapy in patients with chronic hepatitis B resistant to both lamivudine and adefovir?

( Yuri Cho ),( Dong Hyeon Lee ),( Kwang Hyun Chung ),( Jeong Hoon Lee ),( Eun Ju Cho ),( Eun Sun Jang ),( Min Sun Kwak ),( Su Jong Yu ),( Jin Wook Kim ),( Sook Hyang Jeong ),( Jung Hwan Yoon ),( Hyo S 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: The efficacy of adefovir (ADV) plus entecavir (ETV) combination in patients with chronic hepatitis B (CHB) who developed multidrug resistance had not been fully evaluated. We aimed to evaluate the efficacy of ADV plus ETV as compared to that of LAM plus ADV in patients with antiviral resistance to both LAM and ADV. Methods: 27 patients were treated with a combination of ADV plus ETV and 63 patients were treated with a combination of LAM plus ADV. The virological and biochemical parameters were compared between the two groups. Results: Treatment with a combination of ADV plus ETV produced a significantly superior in virological response compared to that in the LAM plus ADV group during 12 months of therapy. At 12 months, the HBV DNA declined more in the ADV plus ETV than in the LAM plus ADV (-4.52 ± 1.956 vs. -2.65 ± 1.723 log10IU/mL; p = 0.001). The rate of a complete response at 12 months was greater in the ADV plus ETV than that in the LAM plus ADV (73.68% vs. 31.48%, p = 0.005). Conclusions: In patients with CHB resistant to both LAM and ADV, the response to ADV plus ETV was significantly superior compared to that of the LAM plus ADV for suppressing HBV DNA through 12 months. The result indicates that ADV plus ETV rather than LAM plus ADV might be used as a bridging therapy in patients with CHB resistant to both LAM and ADV, especially in areas where tenofovir is not available.

Combination therapy involving HSP90 inhibitors for combating cancer: an overview of clinical and preclinical progress

Liu Yajun,Li Chenyao,Liu Hongwei,Tan Shutao 대한약학회 2024 Archives of Pharmacal Research Vol.47 No.5

The molecular chaperone heat shock protein 90 (HSP90) regulates multiple crucial signalling pathways in cancer by driving the maturation of key signalling components, thereby playing a crucial role in tumorigenesis and drug resistance in cancer. Inhibition of HSP90 results in metastable conformational collapse of its client proteins and their proteasomal degradation. Considerable efforts have been devoted to the development of small-molecule inhibitors targeting HSP90, and more than 20 inhibitors have been evaluated in clinical trials for cancer therapy. However, owing to disadvantages such as organ toxicity and drug resistance, only one HSP90 inhibitor has been approved for use in clinical settings. In recent years, HSP90 inhibitors used in combination with other anti-cancer therapies have shown remarkable potential in the treatment of cancer. HSP90 inhibitors work synergistically with various anti-cancer therapies, including chemotherapy, targeted therapy, radiation therapy and immunotherapy. HSP90 inhibitors can improve the pharmacological effects of the above-mentioned therapies and reduce treatment resistance. This review provides an overview of the use of combination therapy with HSP90 inhibitors and other anti-cancer therapies in clinical and preclinical studies reported in the past decade and summarises design strategies and prospects for these combination therapies. Altogether, this review provides a theoretical basis for further research and application of these combination therapies in the treatment of cancer.