Document Detail


Tailoring treatment duration to 12 to 16 weeks in hepatitis C genotype 2 or 3 with rapid virologic response: systematic review and meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  20375729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Current treatment for genotype (GT) 2 or 3 hepatitis C virus infection is pegylated interferon and ribavirin (RBV) 800 mg/d for 24 weeks. This meta-analysis was carried out to assess whether the treatment duration can be reduced in patients with rapid virologic response (RVR) METHODS: Literature was searched for studies comparing short-term (12 to 16 wk) and 24 weeks treatment in GT 2 or 3 with RVR.
RESULTS: Six studies (n=2434) were included and data on end-of-treatment response (ETR), sustained virologic response (SVR), and relapse rates (RR) were obtained. Pooled odds ratio (95% CI) for SVR and RR were 0.54 (0.35-0.85; P=0.008) and 3.12 (1.99-4.91; P<0.00001) favoring 24 weeks of treatment. Reducing treatment duration to 12 to 16 weeks and retreating relapses for 24 weeks was cost-effective.
CONCLUSIONS: Reducing treatment duration to 12 to 16 weeks for GT 2 or 3 HCV patients with RVR is associated with a lower SVR and a higher RR. Advantages of short-term treatment include better patient compliance, lower rate of adverse effects, and cost. Short-term treatment may be an option for patients unable to tolerate treatment. Further studies are needed to identify factors predicting relapse with short-term treatment in GT 2 or 3 patients with RVR.
Authors:
Ashwani K Singal; Bhupinder S Anand
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  44     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  583-7     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston, TX 77555-0764, USA. aksingal@utmb.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiviral Agents / administration & dosage*,  adverse effects,  therapeutic use
Drug Administration Schedule
Drug Costs
Drug Therapy, Combination
Female
Genotype
Hepacivirus / drug effects*,  genetics
Hepatitis C / drug therapy*,  virology
Humans
Interferon Alfa-2a / administration & dosage,  adverse effects,  therapeutic use
Interferon Alfa-2b / administration & dosage,  adverse effects,  therapeutic use
Male
Medication Adherence
Middle Aged
Polyethylene Glycols / administration & dosage,  adverse effects,  therapeutic use
Randomized Controlled Trials as Topic
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Polyethylene Glycols; 0/peginterferon alfa-2a; 0/peginterferon alfa-2b; 76543-88-9/Interferon Alfa-2a; 99210-65-8/Interferon Alfa-2b
Comments/Corrections
Comment In:
J Clin Gastroenterol. 2010 Sep;44(8):527-8   [PMID:  20628314 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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