Back to Journals » Clinical and Experimental Gastroenterology » Volume 5

Differences in clinical outcomes among hepatitis C genotype 1-infected patients treated with peginterferon alpha-2a or peginterferon alpha-2b plus ribavirin: a meta-analysis

Authors Druyts E, Mills EJ, Nachega J, O’Regan C, Cooper CL

Received 15 November 2011

Accepted for publication 13 January 2012

Published 14 February 2012 Volume 2012:5 Pages 11—21

DOI https://doi.org/10.2147/CEG.S28253

Review by Single anonymous peer review

Peer reviewer comments 2


Eric Druyts1, Edward J Mills1,2, Jean Nachega3, Christopher O'Regan4, Curtis L Cooper5

1Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; 2Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; 3Centre for Infectious Diseases, Stellenbosch University, Stellenbosch, South Africa; 4Division of Outcomes Research, Merck, Shire and Dohme, Hoddesdon, UK; 5Division of Infectious Diseases, University of Ottawa at The Ottawa Hospital, Ottawa, ON, Canada

Background: With the development of new direct acting antiviral (DAA) therapy for hepatitis C, the backbone peginterferon alpha used may be of importance in maximizing treatment outcomes. To this end, the rates of sustained virologic response (SVR), relapse, and treatment discontinuation among hepatitis C genotype 1-infected patients given peginterferon alpha-2a plus ribavirin or peginterferon alpha-2b plus ribavirin were determined using a meta-analysis.
Methods: Randomized trials examining peginterferon alpha-2a or peginterferon alpha-2b co-administered with ribavirin for 48 weeks were included. Data were extracted on SVR, relapse, and treatment discontinuations for treatment-naïve and treatment-experienced patients. Pooled proportions using fixed and random effects meta-analysis were calculated.
Results: Twenty-six trials provided data on patients treated with peginterferon alpha-2a plus ribavirin, and 19 trials provided data on patients treated with peginterferon alpha-2b plus ribavirin. Five trials were direct head-to-head evaluations. In the subset of trials that included head-to-head evaluations, no significant differences were observed between the two treatments for treatment-naïve (relative risk [RR]: 1.07, 95% confidence intervals [CI]: 0.97–1.18) and treatment-experienced patients (RR: 1.27, 95% CI: 0.58–2.77). Using only active trial arms, a larger proportion of the treatment-naïve patients who were provided peginterferon alpha-2a plus ribavirin achieved a SVR (47%), which is greater than that of treatment-naïve patients who were provided peginterferon alpha-2b plus ribavirin (40% SVR achievement); however, a larger proportion of treatment-experienced patients who were provided peginterferon alpha-2b plus ribavirin achieved a SVR (16%) when compared with treatment-experienced patients given peginterferon alpha-2a plus ribavirin (12% SVR achievement). A larger proportion of relapses occurred among both treatment-naïve and treatment-experienced patients given peginterferon alpha-2a plus ribavirin, when compared with treatment-naïve and treatment-experienced patients taking peginterferon alpha-2b plus ribavirin. The proportion of patients discontinuing treatment was greater among treatment-naïve patients taking peginterferon alpha-2a plus ribavirin, but smaller among treatment-experienced patients.
Conclusion: There are small differences in treatment outcomes for different types of peginterferon-alpha. Patient status and complexity of administration may differentiate clinical outcomes.

Keywords: hepatitis C, genotype 1, peginterferon, ribavirin, sustained virologic response, meta-analysis

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]