Comparison of peginterferon and interferon in treating Chinese patients with chronic hepatitis C.

BACKGROUND/AIMS: Higher virological and biochemical response rates were obtained in many clinical trials in Caucasian patients with chronic hepatitis C (CHC) after treating with peginterferon than in those with interferon. However, it is not clear whether this conclusion can be extrapolated to patients with Chinese ethnic origin and which type of peginterferon or interferon was more effective in treating Chinese CHC patients? The aim of this study was to perform a meta-analysis of randomized controlled trials (RCT) and compare peginterferon with interferon in treating Chinese patients with CHC.
METHODOLOGY: The outcome measures were virological response (end-of-treatment virological response (ETVR) and sustained virological response (SVR)). Biochemical response (end-of-treatment biochemical response (ETBR) and sustained biochemical response (SBR) were also introduced as supplement to the evaluation on effect of peginterferon and interferon in treating Chinese patients with CHC. The measure of association employed was relative risk (RR) calculated by the random-effect model, with heterogeneity, sensitivity and subgroup analyses.
RESULTS: Of the 110 studies screened, 5 RCTs including 499 patients (peginterferon 258, interferon 241) were analyzed. SVR and SBR obtained in patients treated with peginterferon were significantly higher than patients treated with interferon (60% vs. 35.53%, RR, 1.95; 95% confidence interval (CI), 1.17-3.24; p<0.05; 57.30% vs. 40.38%, RR, 1.36; 95% CI, 1.08-1.71; p<0.05), but the difference is not evident in ETVR and ETBR. In the subgroup analyses, ETVR and SVR obtained in patients treated with peginterferon alpha-2a (79.75% and 48.1%) were significantly higher than with interferon alpha-2a (35.37% vs. 19.05%, RR, 2.51; 95% CI, 1.74-3.63; p<0.05), but the difference is not evident between peginterferon alpha-2b and interferon alpha-2b. SBR obtained with peginterferon was also significantly higher than with interferon (57.3% vs. 40.38%, RR, 1.36; 95% CI, 1.08-1.71; p<0.05), but the difference is not evident in EBVR. Higher SVR were obtained in genotype 1 Chinese patients treated with peginterferon compared with those treated with interferon (48.45% vs. 23.24%, RR, 2.00; 95% CI, 1.48-2.7; p<0.01), but the ETVR were similar. The effects of peginterferon and interferon in genotype non-1 patients were also similar. Higher ETVR and SVR were obtained in patients treated with peginterferon alpha-2b compared with those treated with peginterferon alpha-2a (97.56% vs. 79.75% and 82.93% vs. 56.96%; p<0.05 and p<0.01, respectively). SVR obtained in patients treated with peginterferon alpha-2b were significantly higher than those treated with peginterferon alpha-2a (73.53% vs. 41.73%, p<0.01) in treating genotype 1 Chinese patients, but the superiority didn't appear in treating genotype non-1 patients.
CONCLUSIONS: Both peginterferon alpha-2a and peginterferon alpha-2b might be recommended for Chinese ethnic original patients with CHC. Peginterferon alpha-2b might be more effective, with an expected relative higher virological response and biochemical response, in treating Chinese CHC patients.