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Shortened peginterferon and ribavirin treatment for chronic hepatitis C

Shortened peginterferon and ribavirin treatment for chronic hepatitis C
Shortened peginterferon and ribavirin treatment for chronic hepatitis C
Background: Peginterferon alfa and ribavirin combination therapy is an effective treatment for many patients with chronic hepatitis C virus (HCV). Reducing the length of treatment may be advantageous. We performed a systematic review and economic evaluation to assess shorter treatment duration of this regimen.
Methods: We searched fourteen bibliographic databases (including The Cochrane Library, Medline, and Embase) from 2000 to October 2009 and consulted experts and drug manufacturers. Eligible articles were randomized controlled trials (RCTs) selected according to predefined criteria. We undertook an economic evaluation to assess the cost-effectiveness of shortened treatment versus standard treatment in the UK.
Results: Six trials were included. In the sub-group of patients who had low viral load (LVL) and a rapid virological response (RVR), there were no statistically significant differences in sustained virological response (SVR) rates between patients who received standard treatment (range, 83 percent to 100 percent) and those who received shortened courses (range 84 percent to 96 percent)
(24 weeks for genotype 1, 16 weeks for genotype 2/3). Shortened treatment resulted in cost savings, but in some scenarios also resulted in poorer outcome, compared with standard treatment. This requires a judgment to be made on the value of the quality-adjusted life-year loss resulting from adopting a shorter treatment regimen, if shorter treatment is associated with a lower SVR than standard treatment duration.
Conclusions: For chronic HCV patients who have LVL and achieve an RVR, shortened peginterferon and ribavirin combination therapy could be considered as a viable treatment option.
0266-4623
1-9
Hartwell, Debbie
e6a0eaa0-956d-45fb-9b7d-03ca1af3334c
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Baxter, Louise
c2e955db-6d0e-43c1-8a16-98981727d98e
Shepherd, Jonathan
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Hartwell, Debbie
e6a0eaa0-956d-45fb-9b7d-03ca1af3334c
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Baxter, Louise
c2e955db-6d0e-43c1-8a16-98981727d98e
Shepherd, Jonathan
dfbca97a-9307-4eee-bdf7-e27bcb02bc67

Hartwell, Debbie, Jones, Jeremy, Baxter, Louise and Shepherd, Jonathan (2012) Shortened peginterferon and ribavirin treatment for chronic hepatitis C. International Journal of Technology Assessment in Health Care, 28 (4), 1-9. (doi:10.1017/S0266462312000463).

Record type: Article

Abstract

Background: Peginterferon alfa and ribavirin combination therapy is an effective treatment for many patients with chronic hepatitis C virus (HCV). Reducing the length of treatment may be advantageous. We performed a systematic review and economic evaluation to assess shorter treatment duration of this regimen.
Methods: We searched fourteen bibliographic databases (including The Cochrane Library, Medline, and Embase) from 2000 to October 2009 and consulted experts and drug manufacturers. Eligible articles were randomized controlled trials (RCTs) selected according to predefined criteria. We undertook an economic evaluation to assess the cost-effectiveness of shortened treatment versus standard treatment in the UK.
Results: Six trials were included. In the sub-group of patients who had low viral load (LVL) and a rapid virological response (RVR), there were no statistically significant differences in sustained virological response (SVR) rates between patients who received standard treatment (range, 83 percent to 100 percent) and those who received shortened courses (range 84 percent to 96 percent)
(24 weeks for genotype 1, 16 weeks for genotype 2/3). Shortened treatment resulted in cost savings, but in some scenarios also resulted in poorer outcome, compared with standard treatment. This requires a judgment to be made on the value of the quality-adjusted life-year loss resulting from adopting a shorter treatment regimen, if shorter treatment is associated with a lower SVR than standard treatment duration.
Conclusions: For chronic HCV patients who have LVL and achieve an RVR, shortened peginterferon and ribavirin combination therapy could be considered as a viable treatment option.

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More information

Published date: 2012
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 343412
URI: http://eprints.soton.ac.uk/id/eprint/343412
ISSN: 0266-4623
PURE UUID: 86d8096b-502e-4f91-9f95-1f4402de7e4a
ORCID for Jonathan Shepherd: ORCID iD orcid.org/0000-0003-1682-4330

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Date deposited: 04 Oct 2012 14:43
Last modified: 15 Mar 2024 02:48

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Contributors

Author: Debbie Hartwell
Author: Jeremy Jones
Author: Louise Baxter

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