Interferon versus ribavirin plus interferon in chronic hepatitis C previously resistant to interferon: a randomized trial

Salmerón, Javier; Ruíz-Extremera, Ángela; Torres, Cristina; Rodríguez‐Ramos, Luis; Lavín, Isabel; Quintero, D.; Palacios, A.

doi:10.1111/j.1478-3231.1999.tb00049.x

Cited by 32 publications

(24 citation statements)

References 26 publications

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“…G 12 from the previous assessment report [90][91][92][93][94][95][96][97][98][99][100][101] G an additional five from other systematic reviews [102][103][104][105][106] G three from the updated February 2003 search.…”

Section: Results From the Meta-analysismentioning

confidence: 99%

Pegylated interferon alpha-2a and -2b in combination with ribavirin in the treatment of chronic hepatitis C: a systematic review and economic evaluation

Shepherd

Brodin²,

Cave³

et al. 2004

Health Technol Assess

191

133

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Section: Results From the Meta-analysismentioning

confidence: 99%

Pegylated interferon alpha-2a and -2b in combination with ribavirin in the treatment of chronic hepatitis C: a systematic review and economic evaluation

Shepherd

Brodin²,

Cave³

et al. 2004

Health Technol Assess

191

133

View full text Add to dashboard Cite

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“…For the treatment of HCV-infected and relapsed patients, interferon is used separately or in combination with ribavirin or ursodeoxycholic acid [Lirussi et al, 1999;Salmeron et al, 1999]. However, interferon is inconvenient to use and can cause complications.…”

Section: Discussionmentioning

confidence: 99%

Factors predictive of response to interferon‐α therapy in hepatitis C virus type 1b infection

Yeh¹,

Han²,

Lee³

et al. 2002

Journal of Medical Virology

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Interferon-alpha (IFN-alpha) has been used to treat hepatitis C Virus (HCV)-induced infection but has been effective in only about half of all patients. It is suggested that the different responses to IFN-alpha treatment in HCV infection may be influenced by HCV genotypes, HCV RNA titer at the beginning of IFN-alpha therapy, and the sequences of the interferon sensitivity determining region (ISDR). However, there have also been reports showing that these have no relation to an IFN-alpha effect. In a previous study, it was found that the nucleotide sequence variation in the hypervariable region (HVR) 1 of the HCV could predict the effect of IFN-alpha. In the present investigation, an attempt was made to determine the predictive factors of IFN-alpha therapy. Twenty-six patients with HCV infection were treated with IFN-alpha. Among these, 13 patients recovered after 3 to 6 months of IFN-alpha treatment, although the other 13 patients showed no response after 6 months of treatment with IFN-alpha. In order to determine the predictive factors of IFN-alpha therapy, the ALT levels, HCV genotypes, HCV serum titer, and the quasispecies of HVR 1 were compared between responders and non-responders. It is suggested that the variation in the HVR 1 and HCV serum titer can be used to predict the effect of IFN-alpha.

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“…Of these studies, 9 were excluded because they either contained duplicate reports of the same patients, 9,10 or did not fulfill the inclusion criteria. [11][12][13][14][15][16][17] Two studies were conducted by the same lead investigator, who was contacted to ensure that the patient populations did not overlap. 18,19 Thus, 9 randomized controlled trials were used for the primary meta-analysis.…”

Section: Randomized Controlledmentioning

confidence: 99%

Interferon and ribavirin for patients with chronic hepatitis C who did not respond to previous interferon therapy: A meta-analysis of controlled and uncontrolled trials

Cheng

2001

Hepatology

101

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The efficacy of interferon (IFN) combined with ribavirin for the treatment of patients with hepatitis C who failed to respond to initial IFN therapy is not well established. The primary goal of this study was to perform a systematic review of the literature evaluating the efficacy of combination therapy in nonresponders. Studies were retrieved from MEDLINE, abstracts of scientific meetings, and review of the bibliographies of retrieved studies. Controlled trials were included in the primary analysis whereas uncontrolled trials and trials reported as abstracts were included for sensitivity analysis. The primary endpoints were biochemical and virologic response. A combined estimate of the odds ratio (OR) for each endpoint was obtained by using the random effects model. The number needed to treat (NNT) was calculated by taking the inverse of the pooled risk difference. Nine controlled trials (789 patients) were identified. Six months after treatment, the overall sustained biochemical and virologic responses to 24 weeks of combination therapy were 15.2% and 13.2% with a common OR of 3.8 (95% confidence interval [CI] 2.2-6.7) and 4.9 (95% CI 2.1-11.2) compared with patients treated with IFN monotherapy. The pooled risk difference for the sustained virologic response (SVR) to combination therapy was 7% (95% CI 2-13). The NNT was 14 (95% CI Chronic hepatitis C virus (HCV) infection is a major cause of liver disease worldwide. 1 Interferon (IFN) alfa was the first approved therapy but resulted in a sustained virologic response (SVR) in only a minority of patients. A major advance in treatment was the observation that the addition of ribavirin to IFN (combination therapy) was associated with a significantly higher SVR rate compared with IFN alone. Four large, international multicenter studies have shown that combination therapy was substantially more effective than IFN monotherapy in patients who had previously relapsed virologically or biochemically after IFN monotherapy (relapsers), and in patients who had never been treated with IFN (naive patients). [2][3][4][5] Much less is known about the efficacy of combination therapy in patients who failed to respond to IFN monotherapy (nonresponders), a group representing more than one half of all patients treated with IFN. 6 A number of uncontrolled studies and an increasing number of controlled trials have suggested that the efficacy of re-treatment with combination therapy may be higher than for re-treatment with IFN alone. However, the rate of SVR after combination therapy in nonresponders has varied among available reports. Furthermore, the extent to which a response can be predicted by patient-or treatment-related characteristics remains uncertain. Thus, the primary goal of this study was to assess the available evidence showing the efficacy of combination therapy in nonresponders by performing a systematic review of the literature with a meta-analysis of controlled trials.8

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Interferon versus ribavirin plus interferon in chronic hepatitis C previously resistant to interferon: a randomized trial

Abstract: In conclusion, the combination of 3 MU of interferon plus 600 mg of ribavirin is not effective in chronic hepatitis C resistant to interferon.

Cited by 32 publications

References 26 publications

Pegylated interferon alpha-2a and -2b in combination with ribavirin in the treatment of chronic hepatitis C: a systematic review and economic evaluation

Pegylated interferon alpha-2a and -2b in combination with ribavirin in the treatment of chronic hepatitis C: a systematic review and economic evaluation

Factors predictive of response to interferon‐α therapy in hepatitis C virus type 1b infection

Interferon and ribavirin for patients with chronic hepatitis C who did not respond to previous interferon therapy: A meta-analysis of controlled and uncontrolled trials

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