Lymphoblastoid interferon therapy in chronic hepatitis C: biochemical, virological and histological evaluation of two different doses

Picciotto, Antonino; Callea, Francesco; Varagona, G.; Bardellini, E.; Borzone, S.; Conca, Veronica; Vallarino, E.; Giudici-Cipriani, A; Vitali, A.; Grasso, Alessandro; Palombino, Maria Anna; Dodero, M; Marenco, G; Menardo, G.; Celle, G

doi:10.1111/j.1600-0676.1995.tb00101.x

Cited by 18 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In comparison to previous meta‐analysis [1], 27 RCTs comparing different regimens [34–59] were totalled with 15 newly identified RCTs. Clinical characteristics are described in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 20 RCTs published in 19 full papers [34–52] compared dose effect, including 11 comparisons [34–43] of ‘high dose’ vs. the ‘standard dose’ of 3 MU (seven for 6 months, four for 12 months), and nine other comparisons [44–52]. The randomization process of one trial is doubtful [51], but nevertheless this trial has been included.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Meta‐analysis of interferon randomized trials in the treatment of viral hepatitis C in naive patients: 1999 Update

Thévenot

Regimbeau

Ratziu

et al. 2001

Journal of Viral Hepatitis

View full text Add to dashboard Cite

The aim of this study was to update our previous meta‐analysis of interferon (IFN) in the treatment of hepatitis C and to analyse new factors, namely, HCV RNA end‐point, patients with cirrhosis and patients with normal ALT. We use the Der Simonian and Laird method, with heterogeneity and sensitivity analyses. Seventy‐six randomized control trials (RCTs) in naive patients were found but we focused our analysis on 59 RCTs with chronic hepatitis C (26 vs. controls and 33 comparing different regimens) and on seven RCTs in acute hepatitis. Interferon‐α (IFN‐α) at 3 MU thrice weekly (TIW) for 12 months exhibited 39% of virological end‐of‐treatment response (ETR) and 17% of virological sustained response (SR), respectively, vs. 1% and 3% in untreated controls (all P < 0.001). There was a significant dose effect (in favour of 6 vs. 3 MU TIW): the virological SR at 6 months were 35% in the 6 MU group (95% CI: 24–47) and 16% in the 3 MU group (95% CI: 8–27) and were at 12 months 43% in the 6 MU group (95%CI: 31–56) and 25% in the 3 MU group (95% CI: 16–37). There was a significant duration effect (12 vs. 6 months) upon the virological SR rate both at 3 and 6 MU: 3 MU provided 14% of virological SR (95% CI: 11–19) in the 12 months group vs. 7% (95% CI: 5–11) in the 6 months group and 6 MU provided 22% (95% CI: 17–29) and 16% (95% CI: 11–22) virological SR in the 12 and 6 months groups, respectively. Cirrhotic treated patients had 17% of virological SR (95 CI: 9–24%; P < 0.001) vs. 0% in controls and provided a 20% reduction rate (95 CI: −2% to −37%, P=0.03) in hepatocellular carcinoma incidence. In acute hepatitis C, a 3‐month treatment with IFN‐α showed significant efficacy vs. controls upon the virological SR rate (32% vs. 4%, P < 0.001). In conclusion, we confirm the dose and duration effect of IFN in chronic hepatitis C, and the efficacy of IFN‐α in the treatment of acute hepatitis and in cirrhotic patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of interferon randomized trials in the treatment of viral hepatitis C in naive patients: 1999 Update

Thévenot

Regimbeau

Ratziu

et al. 2001

Journal of Viral Hepatitis

View full text Add to dashboard Cite

show abstract

Pretreatment Evaluation of Chronic Hepatitis C

Wong

Bennett²,

Koff³

et al. 1998

JAMA

178

View full text Add to dashboard Cite

Context.-Chronic hepatitis C (CHC) infection affects nearly 4 million people in the United States. Treatment with interferon alfa-2b has been limited by its cost and low likelihood of long-term response. Objective.-To examine the cost-effectiveness of alternative pretreatment management strategies for patients with CHC. Design.-Decision and cost-effectiveness analysis using a Markov model to examine prevalence of genotypes, viral load, and histological characteristics in relation to the sustained response rate with treatment. Data were based on a previously published decision model and a MEDLINE literature search for hepatitis C, biopsy, and liver from 1966 to 1996. Patients.-A hypothetical population of patients with CHC infection and elevated serum alanine aminotransferase level. Interventions.-Combinations of liver biopsy, genotyping, and quantitative viral load determination prior to a single 6-month course of interferon alfa-2b; empirical interferon treatment; and conservative management. Main Outcome Measures.-Proportion of sustained responders, lifetime costs, life expectancy, and quality-adjusted life expectancy. Results.-Strategies involving hepatitis C virus (HCV) RNA testing had marginal cost-effectiveness ratios up to $4400 per discounted quality-adjusted life-year gained but would miss up to 36% of sustained responders. Empirical interferon treatment had a marginal cost-effectiveness ratio of $12 400 per discounted quality-adjusted life-year gained and reached all potential sustained responders. Strategies involving liver biopsy were more expensive and would miss 6% of sustained responders and yield slightly lower life expectancies. Conclusions.-Routine liver biopsy before treatment with interferon increases the cost of managing patients with CHC without improving health outcomes. Using quantitative HCV RNA testing to guide therapy misses some potential sustained responders. Empirical interferon treatment has a marginal cost-effectiveness ratio within the bounds of other commonly accepted therapies and misses none of the sustained responders.

show abstract

Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: Effects of dose and duration

et al. 1996

View full text Add to dashboard Cite

The aims of this study were to evaluate the benefits of higher doses or of longer duration in comparison with a standard interferon regimen (3 MU three times per week for 6 months) in chronic hepatitis C, and to assess the efficacy of interferon in acute hepatitis C. Meta-analysis made use of the Peto et al. and the Der Simonian and Laird methods, with heterogeneity and sensitivity analyses. In chronic hepatitis, a total of 17 trials versus controls and of 16 trials comparing different interferon regimens were included. Standard regimen, 3 MU three times per week for 6 months, was associated with an increase of the complete alanine transaminase (ALT) response rate and sustained (ALT) response rate by 45% (95% confidence interval: 35% to 55%; P < .001) and 21% (13% to 28%; P < .001), respectively, with the natural course being less than 2% of spontaneous responses. There was a significant dose effect (6 vs. 3 MU three times per week) upon the sustained response rate at 12 months, with a mean 17% increase (7% to 28%; P < .001), but not at 6 months. There was a significant duration effect (12 vs. 6 months) upon the sustained response rate both at the dose of 3 MU with a mean of 16% (9% to 23%; P < .001), and at the dose of 6 MU three times per week with a mean of 20% (7% to 33%; P = .003). In acute hepatitis C, 3 months of interferon treatment showed significant efficacy versus controls (4 trials), upon the complete ALT response (69% vs. 29%; P < .001), the sustained response rate during the 12 months following treatment (53% vs. 32%; P = .02), and hepatitis C virus (HCV)-RNA clearance (41% vs. 4%; P < .001). The best efficacy/risk ratio was in favor of 3 MU three times per week for at least 12 months in patients with chronic hepatitis C who had never been treated with interferon. Patients with acute hepatitis should be treated with at least 3 MU three times per week for 3 months.

show abstract

Lymphoblastoid interferon therapy in chronic hepatitis C: biochemical, virological and histological evaluation of two different doses

Cited by 18 publications

References 23 publications

Meta‐analysis of interferon randomized trials in the treatment of viral hepatitis C in naive patients: 1999 Update

Meta‐analysis of interferon randomized trials in the treatment of viral hepatitis C in naive patients: 1999 Update

Pretreatment Evaluation of Chronic Hepatitis C

Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: Effects of dose and duration

Contact Info

Product

Resources

About