A RANDOMIZED PROSPECTIVE CLINICAL TRIAL COMPARING PEGYLATED INTERFERON ALPHA 2a/RIBAVIRIN VERSUS PEGYLATED INTERFERON ALPHA 2b/RIBAVIRIN IN THE TREATMENT OF CHRONIC HEPATITIS C

Sunita, S.; Gulur, Prasanna; Patel, Vishal; Hage-Nassar, George; Tenner, Scott

doi:10.14309/00000434-200410001-00236

Cited by 6 publications

(5 citation statements)

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“…Figure 1 shows the results of the study screening. Twelve trials, including a total number of 5,008 participants,3, 20–30 that met our inclusion criteria31 were retrieved. All trials compared peginterferon alpha‐2a (180 μg/week) versus peginterferon alfa‐2b (1‐1.5 μg/kg/week).…”

Section: Resultsmentioning

confidence: 99%

“…The meta‐analysis using intention‐to‐treat analysis for SVR included eight trials (4,335 participants) 3, 23–26, 28–30. Overall, peginterferon alpha‐2a significantly increased the number of patients who achieved an SVR (47%) versus peginterferon alfa‐2b (41%) (RR 1.11, 95% CI 1.04–1.19; P = 0.004).…”

Section: Resultsmentioning

confidence: 99%

“…Adverse events leading to treatment discontinuation were reported in 11 trials 3, 20–22, 24–30. Data from these trials yielded an RR of 0.79 (95% CI 0.51–1.23).…”

Section: Resultsmentioning

confidence: 99%

“…Two of the eight included trials in the meta‐analysis for SVR are only available as abstracts. However, we were able to successfully retrieve the necessary data for one of the two abstracts via e‐mail correspondence with the authors,28 and thus, the bias risk assessment of the included trial was performed to a satisfactory extent. Our sensitivity analysis did not show any important changes.…”

Section: Discussionmentioning

confidence: 99%

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Peginterferon alpha‐2a is associated with higher sustained virological response than peginterferon alfa‐2b in chronic hepatitis C

et al. 2010

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A combination of weekly pegylated interferon (peginterferon) alpha and daily ribavirin represents the standard of care for the treatment of chronic hepatitis C according to current guidelines. It is not established which of the two licensed products (peginterferon alpha-2a or peginterferon alfa-2b) is most effective. We performed a systematic review of head-tohead randomized trials to assess the benefits and harms of the two treatments. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and LILACS through July 2009. Using standardized forms, two reviewers independently extracted data from each eligible trial report. We statistically combined data using a random effects metaanalysis according to the intention-to-treat principle. We identified 12 randomized clinical trials, including 5,008 patients, that compared peginterferon alpha-2a plus ribavirin versus peginterferon alfa-2b plus ribavirin. Overall, peginterferon alpha-2a significantly increased the number of patients who achieved a sustained virological response (SVR) versus peginterferon alfa-2b (47% versus 41%; risk ratio 1.11, 95% confidence interval 1.04-1.19; P ‫؍‬ 0.004 [eight trials]). Subgroup analyses of risk of bias, viral genotype, and treatment history yielded similar results. The meta-analysis of adverse events leading to treatment discontinuation included 11 trials and revealed no significant differences between the two peginterferons. Conclusion: Current evidence suggests that peginterferon alpha-2a is associated with higher SVR than peginterferon alfa-2b. However, the paucity of evidence on adverse events curbs the decision to definitively recommend one peginterferon over the other, because any potential benefit must outweigh the risk of harm. (HEPATOLOGY 2010;51:1176-1184 G lobally, an estimated 170 million people are chronically infected with hepatitis C virus, and 3 to 4 million persons are infected each year. 1 Analysts estimate the United States prescription market for hepatitis C to be approximately $3 billion annually. A combination of weekly subcutaneous injections of longacting pegylated interferon (peginterferon) and oral ribavirin represents the current standard of care according to the American Association for the Study of Liver Diseases practice guideline. 2 Currently, there are two licensed products: peginterferon alpha-2a (Pegasys, Hoffmann-La Roche) and peginterferon alfa-2b (PegIntron, ScheringPlough Corporation). Lately, there has been considerable controversy over which treatment options are the most Abbreviations: CI, confidence interval; GRADE, Grading of Recommendations Assessment, Development, and Evaluation; OIS, optimum information size; peginterferon, pegylated interferon; RCT, randomized clinical trial; RR, risk ratio; SVR, sustained virological response. From the

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Adverse events leading to treatment discontinuation were reported in 11 trials 3, 20–22, 24–30. Data from these trials yielded an RR of 0.79 (95% CI 0.51–1.23).…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Peginterferon alpha‐2a is associated with higher sustained virological response than peginterferon alfa‐2b in chronic hepatitis C

et al. 2010

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“…The higher SVR rates achieved by the PegIFN α2a‐based regimen have been confirmed in a recent meta‐analysis from the Cochrane Hepato‐Biliary Group [32] that evaluated the eight randomized studies with intention‐to‐treat analysis that have investigated the efficacy of the two PegIFN regimens (Table 1) [22–24, 33–37]. Awad and co‐workers reveal that in 4335 treatment‐naïve patients, the PegIFN α2a‐based regimen significantly increased the number of patients achieving SVR compared to the PegIFN α2b‐based regimen (47% vs 41%), with PegIFN α2a carrying a relative risk for a SVR of 1.11 (95% CI: 1.04–1.19).…”

Section: Treatment Efficacy In Hcv Patientsmentioning

confidence: 86%

Comparative trials of peginterferon α2a and peginterferon α2b for chronic hepatitis C

Rumi

Aghemo

Prati

2012

Journal of Viral Hepatitis

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Standard of care for patients with chronic hepatitis C is pegylated interferon (pegIFN) combined with ribavirin (Rbv). It results in persistent viral eradication and prevents the progression of liver disease and the associated complications in about 50% of treated patients. Currently, two PegIFNs are available that differ significantly in terms of pharmacokinetic and pharmacodynamic profiles as a consequence of different pegylation chemistries. While the registration trials of the two therapeutic regimens demonstrated the superiority of each PegIFN vs the native IFN α2b, the superiority of one regimen over the other in terms of treatment efficacy remains unknown. Retrospective cohort studies and randomized prospective head-to-head trials have attempted to resolve the considerable controversy over this issue and support evidence-based treatment decisions.

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Peginterferon Alfa-2a Is Superior to Peginterferon Alfa-2b in the Treatment of Naïve Patients with Hepatitis C Virus Infection: Meta-Analysis of Randomized Controlled Trials

2011

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A RANDOMIZED PROSPECTIVE CLINICAL TRIAL COMPARING PEGYLATED INTERFERON ALPHA 2a/RIBAVIRIN VERSUS PEGYLATED INTERFERON ALPHA 2b/RIBAVIRIN IN THE TREATMENT OF CHRONIC HEPATITIS C

Cited by 6 publications

References 0 publications

Peginterferon alpha‐2a is associated with higher sustained virological response than peginterferon alfa‐2b in chronic hepatitis C

Peginterferon alpha‐2a is associated with higher sustained virological response than peginterferon alfa‐2b in chronic hepatitis C

Comparative trials of peginterferon α2a and peginterferon α2b for chronic hepatitis C

Peginterferon Alfa-2a Is Superior to Peginterferon Alfa-2b in the Treatment of Naïve Patients with Hepatitis C Virus Infection: Meta-Analysis of Randomized Controlled Trials

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