As part of AP&T's peer-review process, a technical check of this meta-analysis was performed by Dr P Collins.
Meta-analysis: ribavirin plus interferon vs. interferon monotherapy for chronic hepatitic C – an updated Cochrane review
Article first published online: 16 AUG 2010
© 2010 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 32, Issue 7, pages 840–850, October 2010
How to Cite
Brok, J., Gluud, L.-L. and Gluud, C. (2010), Meta-analysis: ribavirin plus interferon vs. interferon monotherapy for chronic hepatitic C – an updated Cochrane review. Alimentary Pharmacology & Therapeutics, 32: 840–850. doi: 10.1111/j.1365-2036.2010.04423.x
- Issue published online: 3 SEP 2010
- Article first published online: 16 AUG 2010
- Publication data Submitted 3 May 2010 First decision 4 June 2010 Resubmitted 9 July 2010 Accepted 14 July 2010 EV Pub Online 16 August 2010
Aliment Pharmacol Ther 2010; 32: 840–850
Background Multiple randomized trials have been published on antiviral treatment for chronic hepatitis C.
Aim To meta-analyse the effect of adding ribavirin to interferon for chronic hepatitis C.
Methods The results of randomized trials were combined in cumulative meta-analyses. Trial sequential analyses were used to adjust for spurious results because of random errors and multiplicity. The outcome measures were undetectable hepatitis C virus RNA in serum (sustained virological response) and liver-related morbidity plus all-cause mortality.
Results We included 82 randomized trials with 12 615 patients. Trial sequential analysis established clear beneficial effect of interferon plus ribavirin vs. interferon on the sustained virological response in 1998 after nine trials (RR: 0.74; 95% CI: 0.64–0.85, P < 0.0001, 1734 patients). Subsequently, additional 73 trials were published just narrowing the confidence interval and decreasing the P-value. By contrast, trial sequential analysis found that additional evidence is needed to convincingly detect a beneficial effect of interferon plus ribavirin vs. interferon monotherapy on clinical outcomes.
Conclusions The rationale behind several recent trials on adding ribavirin to interferon for chronic hepatitis C is debatable as the effect on virological response is established. More evidence is needed to assess if adding ribavirin to interferon improves clinical outcomes.