A fixed-dose combination of ledipasvir and sofosbuvir ± ribavirin for treatment of hepatitis C infection: a systematic review and meta-analysis

Background Novel antivirals have shown promising results in the treatment of hepatitis C. Our objective was to perform a meta-analysis of the efficacy and safety of a fixed-dose combination (FDC) of ledipasvir + sofosbuvir and compare outcomes with the addition of ribavirin (RBV) to treatment with the FDC. Methods We searched PubMed, EMBASE, and Cochrane CENTRAL from inception through to 9 February 2017. We used a random effects model to calculate untransformed proportions (PRs) and pooled odds ratios (ORs) with 95% confidence intervals (CIs) to compare outcome measures [sustained virologic response at 12 weeks after treatment completion (SVR12); any, serious, and individual adverse events] between groups receiving the FDC ± RBV. We performed the systematic review according to PRISMA guidelines. Results A total of 21 studies with 3826 patients were included in the meta-analysis. Ledipasvir/sofosbuvir was effective in achieving SVR12 after 8 weeks of therapy in genotype (GT) 1 treatment-naïve patients without cirrhosis (PR 0.941; 95% CI 0.910–0.971; p