A real-world retrospective single-centre study of the cost-effectiveness and long-term outcomes of pegylated interferon for chronic hepatitis B
BACKGROUND: Pegylated interferon (Peg-IFN) is recommended as first-line therapy for chronic hepatitis B (CHB) but has significant side effects and is rarely used compared to oral nucleos(t)ide analogues (NA). There are limited recent clinical efficacy or economic analysis data comparing approved CHB...
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| Veröffentlicht in: | Canadian liver journal 2023-08, Vol.6 (3), p.305 |
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| creator | Syed, Stephen E.Congly Ahsan Haylock-Jacobs, Sarah Israelson, Heidi Pinto, Jacqueline Williams, Sarah Lee, Samuel S Coffin, Carla S |
| description | BACKGROUND: Pegylated interferon (Peg-IFN) is recommended as first-line therapy for chronic hepatitis B (CHB) but has significant side effects and is rarely used compared to oral nucleos(t)ide analogues (NA). There are limited recent clinical efficacy or economic analysis data comparing approved CHB therapy in North America. METHODS: This retrospective study examined clinical outcomes, off-treatment durability, and cost-effectiveness of Peg-IFN versus NA for CHB. Demographic (age, sex, ethnicity), clinical data (i.e., liver tests, hepatitis B virus DNA, serology, transient elastography) and documented side effects were collected by retrospective chart review of patients followed in the University of Calgary Liver Unit who received Peg-IFN therapy from January 2007 to December 2020. The cost-effectiveness of Peg-IFN versus NA therapy was modelled over a 10-year time horizon. RESULTS: Sixty-eight CHB patients were treated with Peg-IFN (median age 45.65, 74% male, 84% Asian); 50/68 (74%) completed 48 weeks of treatment with a median follow-up of 6.54 years (interquartile range 5.07). At the last known follow-up, 23/68 (34%) have not required NA treatment and one had HBsAg loss; 27 have been started on NA. Predictors of obtaining a sustained virological response included being hepatitis B e antigen-negative at treatment end and a quantitative hepatitis B surface antigen |
| doi_str_mv | 10.31.38/canlivj-2022-2043 |
| format | Article |
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There are limited recent clinical efficacy or economic analysis data comparing approved CHB therapy in North America. METHODS: This retrospective study examined clinical outcomes, off-treatment durability, and cost-effectiveness of Peg-IFN versus NA for CHB. Demographic (age, sex, ethnicity), clinical data (i.e., liver tests, hepatitis B virus DNA, serology, transient elastography) and documented side effects were collected by retrospective chart review of patients followed in the University of Calgary Liver Unit who received Peg-IFN therapy from January 2007 to December 2020. The cost-effectiveness of Peg-IFN versus NA therapy was modelled over a 10-year time horizon. RESULTS: Sixty-eight CHB patients were treated with Peg-IFN (median age 45.65, 74% male, 84% Asian); 50/68 (74%) completed 48 weeks of treatment with a median follow-up of 6.54 years (interquartile range 5.07). At the last known follow-up, 23/68 (34%) have not required NA treatment and one had HBsAg loss; 27 have been started on NA. Predictors of obtaining a sustained virological response included being hepatitis B e antigen-negative at treatment end and a quantitative hepatitis B surface antigen <1000 IU/mL. Economic modelling showed that finite Peg-IFN was not cost-effective versus NA at a 10-year time horizon. CONCLUSIONS: PEG-IFN remains a potential treatment for CHB although there is a significant intolerance/failure rate. Using PEG-IFN based on patient preference is reasonable and optimal patient selection may improve treatment cost-effectiveness. KEYWORDS: Canada; health economics; hepatitis B; treatment; viral hepatitis</description><identifier>ISSN: 2561-4444</identifier><identifier>EISSN: 2561-4444</identifier><identifier>DOI: 10.31.38/canlivj-2022-2043</identifier><language>eng</language><publisher>University of Toronto Press</publisher><subject>Biological products industry ; Biological response modifiers ; Comparative analysis ; Economic aspects ; Hepatitis B ; Interferon alfa-2a ; Liver ; Medical economics ; Patient outcomes</subject><ispartof>Canadian liver journal, 2023-08, Vol.6 (3), p.305</ispartof><rights>COPYRIGHT 2023 University of Toronto Press</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids></links><search><creatorcontrib>Syed, Stephen E.Congly Ahsan</creatorcontrib><creatorcontrib>Haylock-Jacobs, Sarah</creatorcontrib><creatorcontrib>Israelson, Heidi</creatorcontrib><creatorcontrib>Pinto, Jacqueline</creatorcontrib><creatorcontrib>Williams, Sarah</creatorcontrib><creatorcontrib>Lee, Samuel S</creatorcontrib><creatorcontrib>Coffin, Carla S</creatorcontrib><title>A real-world retrospective single-centre study of the cost-effectiveness and long-term outcomes of pegylated interferon for chronic hepatitis B</title><title>Canadian liver journal</title><description>BACKGROUND: Pegylated interferon (Peg-IFN) is recommended as first-line therapy for chronic hepatitis B (CHB) but has significant side effects and is rarely used compared to oral nucleos(t)ide analogues (NA). There are limited recent clinical efficacy or economic analysis data comparing approved CHB therapy in North America. METHODS: This retrospective study examined clinical outcomes, off-treatment durability, and cost-effectiveness of Peg-IFN versus NA for CHB. Demographic (age, sex, ethnicity), clinical data (i.e., liver tests, hepatitis B virus DNA, serology, transient elastography) and documented side effects were collected by retrospective chart review of patients followed in the University of Calgary Liver Unit who received Peg-IFN therapy from January 2007 to December 2020. The cost-effectiveness of Peg-IFN versus NA therapy was modelled over a 10-year time horizon. RESULTS: Sixty-eight CHB patients were treated with Peg-IFN (median age 45.65, 74% male, 84% Asian); 50/68 (74%) completed 48 weeks of treatment with a median follow-up of 6.54 years (interquartile range 5.07). At the last known follow-up, 23/68 (34%) have not required NA treatment and one had HBsAg loss; 27 have been started on NA. Predictors of obtaining a sustained virological response included being hepatitis B e antigen-negative at treatment end and a quantitative hepatitis B surface antigen <1000 IU/mL. Economic modelling showed that finite Peg-IFN was not cost-effective versus NA at a 10-year time horizon. CONCLUSIONS: PEG-IFN remains a potential treatment for CHB although there is a significant intolerance/failure rate. Using PEG-IFN based on patient preference is reasonable and optimal patient selection may improve treatment cost-effectiveness. KEYWORDS: Canada; health economics; hepatitis B; treatment; viral hepatitis</description><subject>Biological products industry</subject><subject>Biological response modifiers</subject><subject>Comparative analysis</subject><subject>Economic aspects</subject><subject>Hepatitis B</subject><subject>Interferon alfa-2a</subject><subject>Liver</subject><subject>Medical economics</subject><subject>Patient outcomes</subject><issn>2561-4444</issn><issn>2561-4444</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNptj81uwjAMx6Npk4YYL7BTtJ3D0qRt2iND-5KQduGOQuKUoDRhTWDiKfbKy8QOHLAl-2_7Z0tG6L6gU15MefOkpHf2sCWMMpZDya_QiFV1Qcps12f6Fk1i3FJKWSNYS8sR-pnhAaQj32FwOss0hLgDlewBcLS-c0AU-DTkKu31EQeD0wawCjERMOZEeogRS6-xC74jCYYeh31SoYf4t7CD7uhkAo2tz0MDQ_DYhAGrTVZW4Q3sZLLJRvx8h26MdBEm_3mMlq8vy_k7WXy-fcxnC9K1JSVctqYWVPOKVVq3mpatoVoW-UWuYa1UrWRNayOE0kYKxhpaV9Cshc5jqhgfo8fT2U46WFlvQhqk6m1Uq5kQrKl42dBMPVyg1M5-rc6h6QUou4bequDB2Nw_u_oL_HqGiA</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Syed, Stephen E.Congly Ahsan</creator><creator>Haylock-Jacobs, Sarah</creator><creator>Israelson, Heidi</creator><creator>Pinto, Jacqueline</creator><creator>Williams, Sarah</creator><creator>Lee, Samuel S</creator><creator>Coffin, Carla S</creator><general>University of Toronto Press</general><scope/></search><sort><creationdate>20230801</creationdate><title>A real-world retrospective single-centre study of the cost-effectiveness and long-term outcomes of pegylated interferon for chronic hepatitis B</title><author>Syed, Stephen E.Congly Ahsan ; Haylock-Jacobs, Sarah ; Israelson, Heidi ; Pinto, Jacqueline ; Williams, Sarah ; Lee, Samuel S ; Coffin, Carla S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g940-3a9f670d3525dd9d049f0da14443debcc6ca606f77cdfa7228065e8b7d3de0c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Biological products industry</topic><topic>Biological response modifiers</topic><topic>Comparative analysis</topic><topic>Economic aspects</topic><topic>Hepatitis B</topic><topic>Interferon alfa-2a</topic><topic>Liver</topic><topic>Medical economics</topic><topic>Patient outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Syed, Stephen E.Congly Ahsan</creatorcontrib><creatorcontrib>Haylock-Jacobs, Sarah</creatorcontrib><creatorcontrib>Israelson, Heidi</creatorcontrib><creatorcontrib>Pinto, Jacqueline</creatorcontrib><creatorcontrib>Williams, Sarah</creatorcontrib><creatorcontrib>Lee, Samuel S</creatorcontrib><creatorcontrib>Coffin, Carla S</creatorcontrib><jtitle>Canadian liver journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Syed, Stephen E.Congly Ahsan</au><au>Haylock-Jacobs, Sarah</au><au>Israelson, Heidi</au><au>Pinto, Jacqueline</au><au>Williams, Sarah</au><au>Lee, Samuel S</au><au>Coffin, Carla S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A real-world retrospective single-centre study of the cost-effectiveness and long-term outcomes of pegylated interferon for chronic hepatitis B</atitle><jtitle>Canadian liver journal</jtitle><date>2023-08-01</date><risdate>2023</risdate><volume>6</volume><issue>3</issue><spage>305</spage><pages>305-</pages><issn>2561-4444</issn><eissn>2561-4444</eissn><abstract>BACKGROUND: Pegylated interferon (Peg-IFN) is recommended as first-line therapy for chronic hepatitis B (CHB) but has significant side effects and is rarely used compared to oral nucleos(t)ide analogues (NA). There are limited recent clinical efficacy or economic analysis data comparing approved CHB therapy in North America. METHODS: This retrospective study examined clinical outcomes, off-treatment durability, and cost-effectiveness of Peg-IFN versus NA for CHB. Demographic (age, sex, ethnicity), clinical data (i.e., liver tests, hepatitis B virus DNA, serology, transient elastography) and documented side effects were collected by retrospective chart review of patients followed in the University of Calgary Liver Unit who received Peg-IFN therapy from January 2007 to December 2020. The cost-effectiveness of Peg-IFN versus NA therapy was modelled over a 10-year time horizon. RESULTS: Sixty-eight CHB patients were treated with Peg-IFN (median age 45.65, 74% male, 84% Asian); 50/68 (74%) completed 48 weeks of treatment with a median follow-up of 6.54 years (interquartile range 5.07). At the last known follow-up, 23/68 (34%) have not required NA treatment and one had HBsAg loss; 27 have been started on NA. Predictors of obtaining a sustained virological response included being hepatitis B e antigen-negative at treatment end and a quantitative hepatitis B surface antigen <1000 IU/mL. Economic modelling showed that finite Peg-IFN was not cost-effective versus NA at a 10-year time horizon. CONCLUSIONS: PEG-IFN remains a potential treatment for CHB although there is a significant intolerance/failure rate. Using PEG-IFN based on patient preference is reasonable and optimal patient selection may improve treatment cost-effectiveness. KEYWORDS: Canada; health economics; hepatitis B; treatment; viral hepatitis</abstract><pub>University of Toronto Press</pub><doi>10.31.38/canlivj-2022-2043</doi></addata></record> |
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| ispartof | Canadian liver journal, 2023-08, Vol.6 (3), p.305 |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Biological products industry Biological response modifiers Comparative analysis Economic aspects Hepatitis B Interferon alfa-2a Liver Medical economics Patient outcomes |
| title | A real-world retrospective single-centre study of the cost-effectiveness and long-term outcomes of pegylated interferon for chronic hepatitis B |
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