BACKGROUND: Given the significant side-effects and healthcare costs associated with telaprevir- or boceprevir-combination therapy, identifying patients likely to respond to dual therapy peg-interferon (Peg-IFN)/ribavirin is highly desirable. Since the perception of how large the pool of patients who may achieve rapid virologic response (RVR) is vaguely ascertained, we searched the literature for this information. METHODS: Studies on patients treated with Peg-IFN/ribavirin were identified by searching MEDLINE and analyzed by meta-analysis. The primary end point was weighted estimates of RVR. The influence on race/ethnicity, baseline viremia, type of Peg-IFN, ribavirin dosage, and significant hepatic fibrosis on the results was evaluated. RESULTS: Across 38 studies on 13,219 patients, the fraction of RVR patients was 19.6 %. The only baseline factor influencing RVR was race/ethnicity, with higher rates in Asian (26.7 %) and Caucasian patients (22.5 %). Of the 1,735 RVR patients, 85.1 % attained sustained virologic response (SVR). In these, SVR was influenced by ribavirin dose (86.8 vs. 72.8 % for high or low), type of Peg-IFN (91.8 % for alpha-2b vs. 82.9 % for alpha-2a), and treatment duration (91.7 % for 48 weeks vs. 79.4 % for 24 weeks). CONCLUSIONS: One fifth to one fourth of hepatitis C virus genotype 1 (HCV-1) patients can be safely treated with dual therapy of Peg-IFN/ribavirin, and may be spared from cost and inconvenience of regimens considering the addition of HCV protease inhibitors.
BACKGROUND: Given the significant side-effects and healthcare costs associated with telaprevir- or boceprevir-combination therapy, identifying patients likely to respond to dual therapy peg-interferon (Peg-IFN)/ribavirin is highly desirable. Since the perception of how large the pool of patients who may achieve rapid virologic response (RVR) is vaguely ascertained, we searched the literature for this information. METHODS: Studies on patients treated with Peg-IFN/ribavirin were identified by searching MEDLINE and analyzed by meta-analysis. The primary end point was weighted estimates of RVR. The influence on race/ethnicity, baseline viremia, type of Peg-IFN, ribavirin dosage, and significant hepatic fibrosis on the results was evaluated. RESULTS: Across 38 studies on 13,219 patients, the fraction of RVR patients was 19.6 %. The only baseline factor influencing RVR was race/ethnicity, with higher rates in Asian (26.7 %) and Caucasian patients (22.5 %). Of the 1,735 RVR patients, 85.1 % attained sustained virologic response (SVR). In these, SVR was influenced by ribavirin dose (86.8 vs. 72.8 % for high or low), type of Peg-IFN (91.8 % for alpha-2b vs. 82.9 % for alpha-2a), and treatment duration (91.7 % for 48 weeks vs. 79.4 % for 24 weeks). CONCLUSIONS: One fifth to one fourth of hepatitis C virus genotype 1 (HCV-1) patients can be safely treated with dual therapy of Peg-IFN/ribavirin, and may be spared from cost and inconvenience of regimens considering the addition of HCV protease inhibitors.
Authors: C Brandão; A Barone; F Carrilho; A Silva; M Patelli; C Caramori; R Focaccia; L Pereira; M Pedroso; F Tatsch; M Pessoa Journal: J Viral Hepat Date: 2006-08 Impact factor: 3.728
Authors: José M Sánchez-Tapias; Moisés Diago; Pedro Escartín; Jaime Enríquez; Manuel Romero-Gómez; Rafael Bárcena; Javier Crespo; Raúl Andrade; Eva Martínez-Bauer; Ramón Pérez; Milagros Testillano; Ramón Planas; Ricard Solá; Manuel García-Bengoechea; Javier Garcia-Samaniego; Miguel Muñoz-Sánchez; Ricardo Moreno-Otero Journal: Gastroenterology Date: 2006-08 Impact factor: 22.682
Authors: Alexander J Thompson; Andrew J Muir; Mark S Sulkowski; Dongliang Ge; Jacques Fellay; Kevin V Shianna; Thomas Urban; Nezam H Afdhal; Ira M Jacobson; Rafael Esteban; Fred Poordad; Eric J Lawitz; Jonathan McCone; Mitchell L Shiffman; Greg W Galler; William M Lee; Robert Reindollar; John W King; Paul Y Kwo; Reem H Ghalib; Bradley Freilich; Lisa M Nyberg; Stefan Zeuzem; Thierry Poynard; David M Vock; Karen S Pieper; Keyur Patel; Hans L Tillmann; Stephanie Noviello; Kenneth Koury; Lisa D Pedicone; Clifford A Brass; Janice K Albrecht; David B Goldstein; John G McHutchison Journal: Gastroenterology Date: 2010-04-24 Impact factor: 22.682
Authors: Wendy S C Cheng; Stuart K Roberts; Geoffrey McCaughan; William Sievert; Martin Weltman; Darrell Crawford; William Rawlinson; Philippa S Marks; James Thommes; Bishoy Rizkalla; Motoko Yoshihara; Gregory J Dore Journal: J Hepatol Date: 2010-06-16 Impact factor: 25.083
Authors: Stefan Zeuzem; Mark S Sulkowski; Eric J Lawitz; Vinod K Rustgi; Maribel Rodriguez-Torres; Bruce R Bacon; Mircea Grigorescu; Alan D Tice; Yoav Lurie; Janusz Cianciara; Andrew J Muir; Patrick W Cronin; Erik Pulkstenis; G Mani Subramanian; John G McHutchison Journal: Gastroenterology Date: 2010-06-27 Impact factor: 22.682
Authors: John G McHutchison; Gregory T Everson; Stuart C Gordon; Ira M Jacobson; Mark Sulkowski; Robert Kauffman; Lindsay McNair; John Alam; Andrew J Muir Journal: N Engl J Med Date: 2009-04-30 Impact factor: 91.245
Authors: Stephanos J Hadziyannis; Hoel Sette; Timothy R Morgan; Vijayan Balan; Moises Diago; Patrick Marcellin; Giuliano Ramadori; Henry Bodenheimer; David Bernstein; Mario Rizzetto; Stefan Zeuzem; Paul J Pockros; Amy Lin; Andrew M Ackrill Journal: Ann Intern Med Date: 2004-03-02 Impact factor: 25.391
Authors: J G McHutchison; S C Gordon; E R Schiff; M L Shiffman; W M Lee; V K Rustgi; Z D Goodman; M H Ling; S Cort; J K Albrecht Journal: N Engl J Med Date: 1998-11-19 Impact factor: 91.245