Mesh : Antiviral Agents / administration & dosage adverse effects Confounding Factors, Epidemiologic Drug Administration Schedule Hepacivirus / drug effects genetics isolation & purification Hepatitis C, Chronic / drug therapy Humans Interferon Type I / administration & dosage adverse effects Interferon-alpha Odds Ratio RNA, Viral / blood Randomized Controlled Trials as Topic Recombinant Proteins Treatment Outcome Viral Load

来  源:   DOI:10.1007/s00228-010-0881-7   PDF(Sci-hub)

Abstract:
BACKGROUND: About one-half of patients with hepatitis C genotype 1 and one-third with genotype 2/3 have treatment failure with peginterferon alpha and ribavirin. Consensus interferon (CIFN) is an option for retreatment of these patients.
OBJECTIVE: To summarize comparative safety and efficacy of different regimens of CIFN for the treatment of patients with chronic hepatitis C infection.
METHODS: Medline, Scopus, ISI, and Cochran Central Register of Clinical Trials were used.
METHODS: Randomized clinical trials (RCTs) were eligible for inclusion in the study.
METHODS: HIV and HBV seronegative patients with positive HCV-RNA during the 6 months before the start of the study were eligible for inclusion.
METHODS: Different regimens of CIFN were studied.
METHODS: Studies were appraised based on methods of random sequence generation, allocation concealment, and blinding. The random effects model of DerSimonian and Laird was employed to run the meta-analysis. The end-point was sustained virological response (SVR).
RESULTS: Data of 10 RCTs including 1,600 subjects were extracted. High daily induction dose regimen of CIFN did not yield a higher rate of SVR than low daily induction dose treatment regimen, RR = 0.83 (95% CI 0.58-1.17). A dose of 9 μg thrice weekly (tiw) was associated with a significantly higher rate of SVR compared with 3 μg [RR = 3.14 (95% CI 1.68-5.58)][Symbol: see text]. Withdrawal rate was similar [RR = 1.28 (95% CI 0.65-2.50)] but dose modification was higher in 9 μg [RR = 3.22 (95% CI 1.08-9.60)]. A dose of 18/15 μg tiw was not more effective than 9 μg over a similar treatment duration [RR = 1.02 (95% CI 0. 87-1.19)].
CONCLUSIONS: Limitations include inadequate reporting of methodological information and side effects, lack of publication bias assessment due to the small number of studies in each analysis.
CONCLUSIONS: High dose daily induction therapy with CIFN is not superior to low dose therapy in terms of SVR. It seems that 9 μg tiw is the optimal treatment dose of CIFN for treatment of HCV infection. Optimal duration and safety profile of CIFN therapy have yet been elucidated.
摘要:
暂无翻译
公众号