Ribavirin with or without alpha interferon for chronic hepatitis C

Abstract

Combination therapy increased the number of naive patients, relapsers, and non-responders with a sustained virological, biochemical, or histological response, but also the occurrence of adverse events.

Effectiveness and cost-effectiveness of initial combination therapy with interferon/peginterferon plus ribavirin in patients with chronic hepatitis C in Germany: A health technology assessment commissioned by the German Federal Ministry of Health and Social Security

“…Twelve studies regarding the medical efficacy of combination therapy with interferon plus ribavirin compared to interferon monotherapy were included; herein 2 HTA reports [38], [39] 1 systematic Cochrane review [24], 2 meta-analyses [23], [40] and 7 controlled randomised clinical trials [41], [42], [43], [44], [13], [14], [45]. Two controlled randomised multicentre studies [15], [16] regarding medical efficacy of combination therapy with peginterferon and ribavirin compared to interferon plus ribavirin were identified and included.…”

“…Several randomised trials [41], [42], [43], [44], [13], [14], [45] and meta-analyses [23], [24], [40] reported combination therapy with interferon plus ribavirin to be more efficient than interferon monotherapy (SVR: 32-54% vs. 8-21%). Two randomised multicentre studies [15], [16] reported a higher SVR for peginterferon plus ribavirin compared to combination therapy with interferon plus ribavirin (54-56% vs. 44-47%).…”

“…This model was designed to include pooled effectiveness data from meta-analyses, as well as benefits and costs, for employing different antiviral treatment strategies for patients with chronic hepatitis C. Pooled effectiveness data were derived from meta-analyses performed by the Hepato-Biliary Cochrane Group [23], [24] and additional meta-analyses were performed by the authors. GEHMO is a decision-analytic Markov model based on a previously published and validated Markov model for the natural history of disease [25], [26] and modified for the German health-care system and German hepatitis C-specific practice patterns.…”

“…Relative virological response rates of interferon monotherapy and combination therapy with interferon alpha plus ribavirin were based on a recently published meta-analysis [23] and a Cochrane Review [24]. We performed a meta-analysis to derive pooled virological response rates of combination therapy with peginterferon plus ribavirin published in two randomised clinical multicentre trials [15], [16] (see (Tab.…”