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Meta‐analysis: combination therapy with interferon‐α 2a/2b and ribavirin for patients with chronic hepatitis C previously non‐responsive to interferon
Author(s) -
Miguel R. San,
Guillén F.,
Cabasés J. M.,
Buti M.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01328.x
Subject(s) - ribavirin , medicine , combination therapy , regimen , interferon , odds ratio , alpha interferon , randomized controlled trial , meta analysis , hepatitis c , gastroenterology , clinical trial , chronic hepatitis , immunology , virus
SUMMARY Background : The efficacy of interferon‐α plus ribavirin treatment for patients not responding to interferon monotherapy is not well established. Aim : To assess the efficacy and safety of combination therapy with interferon‐α 2a/2b plus ribavirin by performing a meta‐analysis of randomized clinical trials. Methods : A systematic search of electronic databases for randomized clinical trials of interferon‐α 2a/2b plus ribavirin was conducted independently by two investigators. Data abstraction was performed. The primary end‐point was a sustained virological response. Estimates of the common odds ratio were calculated using a random effects model. Results : Of the 127 identified studies, 46 were considered for evaluation and 10 were included (1728 patients). The pooled sustained virological response was 12.6% (95% CI, 9.5–16.3%) for combination therapy vs. 2% (95% CI, 0.9–4.0%) for interferon monotherapy, with a common odds ratio of 5.49. Higher doses of interferon, a longer duration of therapy (48 weeks) and genotypes other than 1 and 4 were associated with an improvement in response. More side‐effects and discontinuations were observed with combination therapy than with interferon monotherapy. Conclusions : Non‐responders to interferon may benefit from re‐treatment with combination therapy, especially from a 48‐week regimen.