Efficacy and Tolerability of Peginterferonα-2a and Peginterferonα-2b, Both plus Ribavirin, for Chronic Hepatitis C: A Meta-Analysis of Randomized Controlled Trials

Abstract

Background. The efficacy and tolerability of peginterferon α-2a and peginterferon α-2b in chronic hepatitis C (CHC) patients remain controversial. Methods. PubMed, Ovid, and Cochrane libraries were electronically searched until August 30, 2012. Studies that met the inclusion criteria were systematically evaluated by two reviewers independently. Results. The overall sustained virologic response (SVR) rate of the peginterferon α-2a group was significantly higher than that of the peginterferon α-2b group (46.7% versus 42.4%, P value = 0.01). The same tendency was observed for naïve, genotype 1/4, and genotype 2/3 patients. The early virologic response (EVR) and end-of-treatment response (ETR) rates were significantly higher in the peginterferon α-2a group than in the peginterferon α-2b group (56.1% versus 49.8%, P < 0.0001; 67.9% versus 56.6%, P < 0.00001, resp.). Peginterferon α-2a had a significantly lower discontinuation rate than peginterferon α-2b (27.9% versus 33.9%, P < 0.0001) in naïve patients. In both naïve CHC and hepatitis C virus genotype 1 patients, peginterferon α-2a had a higher relapse rate than peginterferon α-2b. Conclusions. Peginterferon α-2a has superior efficacy with higher EVR, ETR, and SVR than peginterferon α-2b for CHC patients, both plus ribavirin. Peginterferon α-2a might obtain a similar or even lower discontinuation rate than peginterferon α-2b. However, peginterferon α-2a had a higher relapse rate than peginterferon α-2b.

Peginterferon Alfa-2a Is Associated with Elevations in Alanine Aminotransferase at the End of Treatment in Chronic Hepatitis C Patients with Sustained Virologic Response

“…Several previous meta-analyses have reported that PEG-IFN-alfa-2a was associated with higher SVR rates than PEG-IFN-alfa-2b [28]–[31]. Treatments with PEG-IFN-alfa-2a might obtain a similar or decreased discontinuation rate than PEG-IFN-alfa-2b [28], [31]. The results of this study confirmed the improved treatment outcome of PEG-IFN-alfa-2a (adjusted OR, 2.91; 95% CI, 1.75–4.83).…”

“…The higher bioavailability of PEG-IFN-alfa-2a may be linked to the treatment efficacy [27]. Several previous meta-analyses have reported that PEG-IFN-alfa-2a was associated with higher SVR rates than PEG-IFN-alfa-2b [28]–[31]. Treatments with PEG-IFN-alfa-2a might obtain a similar or decreased discontinuation rate than PEG-IFN-alfa-2b [28], [31].…”

British HIV Association guidelines for the management of hepatitis viruses in adults infected with HIV 2013

“…Nevertheless, based on the monoinfection analysis, physicians may prefer to utilize pegylated α-interferon 2a [89]. Ribavirin should always be given based on weight (1000 mg per day if less than 75 kg and 1200 mg per day if above this weight) [90].…”

Mental health, pro-inflammatory cytokines, and brain derived neurotrophic factor in patients undergoing treatment for hepatitis C: comparison between peginterferon-alpha-2a and peginterferon-alpha-2b

“…Numerous researchers have found that PegIFNα-2a plus ribavirin yields a higher SVR and a lower discontinuation rate than PegIFN-α-2b plus ribavirin [8][9][10]. However, a review article found that PegIFN-α-2a and PegIFNα-2b exhibit similar degrees of effectiveness and tolerability, with few clinical differences [11].…”