Thus, data from high-quality observational or quasi-experimental studies become critical in the assessment of the overall effectiveness of therapeutic or diagnostic modalities in large patient populations. The recently passed Healthcare Reform Law of 2010 places further emphasis on CER. For example, the law authorizes the establishment of a nonprofit corporation known as the Patient-Centered Outcome Research Institute (PCORI), which is expected to oversee the conduct of CER and dissemination of the research findings.16 The extent to which CER will be supported and used while the reform is implemented
in the coming years selleck kinase inhibitor remains to be seen. It is certain, however, that interest will remain high on promoting research to determine the effectiveness of new (and existing) therapies in the context of usual medical
practice settings within the United States in the foreseeable future. “
“Previous studies have indicated that lamivudine-induced hepatitis B e antigen (HBeAg) seroconversion may not be durable in the Asian population. We investigated the useful predictors of post-treatment hepatitis B virus (HBV) relapse in patients with nucleos(t)ide analogue (NA)-induced HBeAg loss/seroconversion. A total of 157 non-cirrhotic patients with NA-induced HBeAg loss/seroconversion (78, lamivudine; 68, entecavir; 11, telbivudine) were retrospectively analyzed. All patients had at least 12 months of post-treatment follow-up and consolidation therapy duration. The cumulative rate of post-treatment HBV relapse at 5 years was 57.1%. Multivariate analysis revealed that age and baseline XL765 clinical trial hepatitis B surface antigen (HBsAg) levels MCE independently predicted post-treatment HBV relapse. The post-treatment HBV relapse rate was significantly higher in patients aged >40 years than in those <40 years (p< 0.001). A baseline HBsAg level of 2,000 IU/mL was the optimal cut-off value for predicting post-treatment HBV relapse (p=0.002). The post-treatment HBV relapse risk further increased with the presence of both risk factors (age ≥ 40 years and baseline HBsAg level ≥ 2,000 IU/mL; p< 0.001). A prolonged consolidation therapy period of ≥ 18 or 24 months
had no positive effect on sustained viral suppression. There was no significant difference in post-treatment HBV relapse rates between patients with lamivudine- and entecavir-induced HBeAg loss/seroconverion during the off-treatment follow-up (p = 0.31). The combination of an age of 40 years and a baseline HBsAg level of 2,000 IU/mL was a useful marker for predicting post-treatment HBV relapse in patients with NA-induced HBeAg loss/seroconversion. “
“Transarterial chemoembolization (TACE) is the current standard of treatment for unresectable intermediate-stage hepatocellular carcinoma (HCC). Brivanib, a selective dual inhibitor of vascular endothelial growth factor and fibroblast growth factor signaling, may improve the effectiveness of TACE when given as an adjuvant to TACE.