Ribavirin plus interferon versus interferon for chronic hepatitis C

Brok, Jesper; Gluud, Lise Lotte; Gluud, Christian

doi:10.1002/14651858.cd005445

Cited by 28 publications

(22 citation statements)

References 216 publications

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“…Second, you can add the experimental to the evidence-based intervention and compare it with placebo plus the evidencebased intervention (e.g. ribavirin plus interferon versus placebo plus interferon [41]). Third, you may find patients who will not accept or who have contraindications to the evidence-based intervention and randomise them to experimental intervention versus placebo (e.g.…”

Section: Which Comparator: Placebo or Active?mentioning

confidence: 99%

The culture of designing hepato-biliary randomised trials

Gluud

2006

Journal of Hepatology

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Section: Which Comparator: Placebo or Active?mentioning

confidence: 99%

The culture of designing hepato-biliary randomised trials

Gluud

2006

Journal of Hepatology

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“…[124][125][126] However, combination therapy with IFN-α and oral ribavirin is more effective than either drug used alone. 127 Combining oral ribavirin with peginterferon-α may be more effective than combining it with IFN-α. 128,129 Therefore, the British Society for Gastroenterology and the American Association for the Study of Liver Diseases 130 recommends once-weekly SC peginterferon-α combined with oral ribavirin as the first line of treatment of CHC.…”

Section: Interferonsmentioning

confidence: 99%

Antiviral Drugs for Viruses Other Than Human Immunodeficiency Virus

Razonable

2011

Mayo Clinic Proceedings

220

133

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Most viral diseases, with the exception of those caused by human immunodeficiency virus, are self-limited illnesses that do not require specific antiviral therapy. The currently available antiviral drugs target 3 main groups of viruses: herpes, hepatitis, and influenza viruses. With the exception of the antisense molecule fomivirsen, all antiherpes drugs inhibit viral replication by serving as competitive substrates for viral DNA polymerase. Drugs for the treatment of influenza inhibit the ion channel M(2) protein or the enzyme neuraminidase. Combination therapy with Interferon-α and ribavirin remains the backbone treatment for chronic hepatitis C; the addition of serine protease inhibitors improves the treatment outcome of patients infected with hepatitis C virus genotype 1. Chronic hepatitis B can be treated with interferon or a combination of nucleos(t)ide analogues. Notably, almost all the nucleos(t) ide analogues for the treatment of chronic hepatitis B possess anti-human immunodeficiency virus properties, and they inhibit replication of hepatitis B virus by serving as competitive substrates for its DNA polymerase. Some antiviral drugs possess multiple potential clinical applications, such as ribavirin for the treatment of chronic hepatitis C and respiratory syncytial virus and cidofovir for the treatment of cytomegalovirus and other DNA viruses. Drug resistance is an emerging threat to the clinical utility of antiviral drugs. The major mechanisms for drug resistance are mutations in the viral DNA polymerase gene or in genes that encode for the viral kinases required for the activation of certain drugs such as acyclovir and ganciclovir. Widespread antiviral resistance has limited the clinical utility of M(2) inhibitors for the prevention and treatment of influenza infections. This article provides an overview of clinically available antiviral drugs for the primary care physician, with a special focus on pharmacology, clinical uses, and adverse effects.

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“…are believed to enhance disease progression [29]. Standard treatment is pegylated interferon (IFN) plus ribavirin with dose and duration depending on viral genotype, viral load, initial response, and liver histology [30][31][32][33]. The overall aim of antiviral treatment is to prevent long-term clinical symptoms related to the potential cirrhosis development, i.e., ascites, variceal bleeding, hepatic encephalopathy, carcinoma, and death.…”

Section: Do We Have Validated Surrogate Outcome Measures In Hepatology?mentioning

confidence: 99%

“…However, four important aspects of this outcome should be considered. First, only about every second patient may achieve SVR [30][31][32][33]. Second, SVR is not equivalent to eradication of HCV RNA.…”

Section: Do We Have Validated Surrogate Outcome Measures In Hepatology?mentioning

confidence: 99%

“…One meta-analysis of randomised trials on IFN (any type) plus ribavirin versus IFN found absence of evidence that combination therapy improves hepatocellular carcinoma and mortality (RR 0.57, 95% CI 0.23 to 1.40) [32,33]. Likewise a meta-analysis on pegylated IFN plus ribavirin versus non-pegylated IFN plus ribavirin found absence of evidence on improvement of liver-related morbidity and mortality (RR 1.14, 95% CI 0.38 to 3.40) [39].…”

Section: Do We Have Validated Surrogate Outcome Measures In Hepatology?mentioning

confidence: 99%

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