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Meta‐analysis: pegylated interferon α‐2a achieves higher early virological responses than α‐2b in chronic hepatitis C
Author(s) -
RomeroGómez M.,
Planas R.,
Ampuero J.,
Solà R.,
GarcíaSamaniego J.,
Diago M.,
Crespo J.,
Calleja J. L.,
Turnes J.
Publication year - 2013
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 - 10.1111/apt.12314
Subject(s) - medicine , meta analysis , pegylated interferon , gastroenterology , randomized controlled trial , subgroup analysis , chronic hepatitis , ribavirin , immunology , virus
Summary Background A Cochrane meta‐analysis established that pegylated interferon α‐2a is more effective than peginterferon α‐2b in terms of sustained virological response ( SVR ) in the treatment of chronic hepatitis C. Rapid virological response ( RVR ) and early virological response ( EVR ) are crucial to reach SVR and to make clinical decisions. Aim To compare RVR and EVR rates of peginterferon α‐2a vs. peginterferon α‐2b through a meta‐analysis of previously published randomised control trials ( RCT ). Methods MEDLINE, EMBASE and LILACS databases were systematically searched up to September 2011. Seven RCT that reported complete early virological response ( cEVR ) were selected. A meta‐analysis focusing on RVR and cEVR outcomes was conducted and Relative Efficacy (RE) was calculated. Results Meta‐analysis of cEVR included seven trials ( n = 4359), and yielded an estimated effect in favour of peginterferon α‐2a: Crude Efficacy (CEf) was 53.3% vs. 43.8%, RE = 1.118 (CI 95% = 1.039–1.203; P = 0.0028), heterogeneity Q = 8.959; I 2 = 33.0% ( P = 0.1759). A sub‐analysis of three studies with 3409 genotype‐1 patients yielded CEf: 49.4% vs. 40.2%, RE = 1.151 (CI 95% = 0.968–1.369; P = 0.1124), Q = 9.802; I 2 = 79.6% ( P = 0.0074). Meta‐analysis of RVR included five trials ( n = 3833) with an estimated effect in favour of peginterferon α‐2a: CEf = 25.0% vs. 16.8%, RE = 1.151 (CI 95%:1.042–1.272; P = 0.0056), Q = 1.461; I 2 = 0.0% ( P = 0.8335). Analysis of four studies reporting RVR including 3499 patients with genotypes 1 and 4 resulted in CEf: 18.3% vs. 12.7% RE = 1.206 (CI 95% = 1.059–1.374; P = 0.0048), Q = 1.116; I 2 = 0.0% ( P = 0.7733). Conclusions Peginterferon α‐2a may be associated with a higher cEVR and RVR than peginterferon α‐2b. These findings could help to achieve higher SVR rates and support clinical decision‐making in the present scenario of triple combination therapy.