{"id":24672,"date":"2023-12-01T04:37:00","date_gmt":"2023-11-30T20:37:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24672"},"modified":"2023-12-01T05:34:38","modified_gmt":"2023-11-30T21:34:38","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%bc%90%e6%98%94%e6%b4%9b%e9%9f%a6%e6%8a%91%e5%88%b6%e4%b8%ad%e9%87%8d%e5%ba%a6copd%e6%82%a3%e8%80%85%e7%9a%84ebv","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24672","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u4f10\u6614\u6d1b\u97e6\u6291\u5236\u4e2d\u91cd\u5ea6COPD\u60a3\u8005\u7684EBV"},"content":{"rendered":"\n

CHEST INFECTIONS: ORIGINAL RESEARCH|\u00a0VOLUME 164, ISSUE 3<\/a>,\u00a0P625-636,\u00a0SEPTEMBER 2023<\/p>\n\n\n\n

Valaciclovir for Epstein-Barr Virus Suppression in Moderate-to-Severe COPD: A Randomized Double-Blind Placebo-Controlled Trial<\/h1>\n\n\n\n

Dermot A. Linden, Hong Guo-Parke, Michael C. McKelvey, et al<\/h3>\n\n\n\n

Chest 2023; 164: 625-636 Open Access Published:March 31, 2023<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2023.03.040<\/a><\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

Epstein-Barr virus (EBV) frequently is measured at high levels in COPD using sputum quantitative polymerase chain reaction, whereas airway immunohistochemistry analysis has shown EBV detection to be common in severe disease.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Is valaciclovir safe and effective for EBV suppression in COPD?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

The Epstein-Barr Virus Suppression in COPD (EViSCO) trial was a randomized double-blind placebo-controlled trial conducted at the Mater Hospital Belfast, Northern Ireland. Eligible patients had stable moderate-to-severe COPD and sputum EBV (measured using quantitative polymerase chain reaction) and were assigned randomly (1:1) to valaciclovir (1 g tid) or matching placebo for 8 weeks. The primary efficacy outcome was sputum EBV suppression (defined as \u2265 90% sputum viral load reduction) at week 8. The primary safety outcome was the incidence of serious adverse reactions. Secondary outcome measures were FEV1<\/sub> and drug tolerability. Exploratory outcomes included changes in quality of life, sputum cell counts, and cytokines.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

From November 2, 2018, through March 12, 2020, 84 patients were assigned randomly (n\u00a0= 43 to valaciclovir). Eighty-one patients completed trial follow-up and were included in the intention-to-treat analysis of the primary outcome. A greater number of participants in the valaciclovir group achieved EBV suppression (n\u00a0= 36 [87.8%] vs\u00a0n\u00a0= 17 [42.5%];\u00a0P<\/em>\u00a0< .001). Valaciclovir was associated with a significant reduction in sputum EBV titer compared with placebo (\u201390,404 copies\/mL [interquartile range, \u2013298,000 to \u201315,200 copies\/mL] vs\u00a0\u20133,940 copies\/mL [interquartile range, \u2013114,400 to 50,150 copies\/mL];\u00a0P<\/em>\u00a0= .002). A statistically nonsignificant 24-mL numerical FEV1<\/sub>\u00a0increase was shown in the valaciclovir group (difference, \u201344\u00a0mL [95%\u00a0CI, \u2013150 to 62\u00a0mL];\u00a0P<\/em>\u00a0= .41). However, a reduction in sputum white cell count was noted in the valaciclovir group compared with the placebo group (difference, 2.89 [95%\u00a0CI, 1.5\u00a0\u00d7 106<\/sup>-7.4\u00a0\u00d7 106<\/sup>];\u00a0P<\/em>\u00a0= .003).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Interpretation<\/h3>\n\n\n\n

Valaciclovir is safe and effective for EBV suppression in COPD and may attenuate the sputum inflammatory cell infiltrate. The findings from the current study provide support for a larger trial to evaluate long-term clinical outcomes.<\/p>\n\n\n\n

Trial Registry<\/h3>\n\n\n\n

ClinicalTrials.gov; No.: NCT03699904; URL: www.clinicaltrials.gov<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

CHEST INFECTIONS: ORIGINAL RESEARCH|\u00a0VOLUME 164, ISSUE […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24672"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24672"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24672\/revisions"}],"predecessor-version":[{"id":24673,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24672\/revisions\/24673"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24672"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24672"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24672"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}