Direct-acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta-analysis
New direct-acting antiviral agents for hepatitis C genotype 1 infection, boceprevir and telaprevir, offer enhanced sustained virologic response (SVR) among both treatment-naïve and treatment-experienced patients. To determine the relative efficacy of the new direct-acting antiviral agents by applyin...
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| Veröffentlicht in: | QJM : An International Journal of Medicine 2013-02, Vol.106 (2), p.153-163 |
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| creator | Cooper, C Lester, R Thorlund, K Druyts, E El Khoury, A C Yaya, S Mills, E J |
| description | New direct-acting antiviral agents for hepatitis C genotype 1 infection, boceprevir and telaprevir, offer enhanced sustained virologic response (SVR) among both treatment-naïve and treatment-experienced patients.
To determine the relative efficacy of the new direct-acting antiviral agents by applying a multiple treatment comparison meta-analysis.
We included published Phase II and III randomized controlled trials evaluating head-to-head comparisons between boceprevir, telaprevir, peg-interferon alpha-2a with ribavirin and peg-interferon alpha-2b with ribavirin in hepatitis C genotype 1 patients. We applied Bayesian multiple treatment comparison meta-analysis.
We included data from four boceprevir, three telaprevir and six peg-interferon alpha-2a plus ribavirin vs. peg-interferon alpha-2b plus ribavirin randomized controlled trials. Both boceprevir and telaprevir offer statistically superior outcomes for SVR, relapse and discontinuation due to adverse events than either peg-interferons among both treatment-naïve and treatment-experienced patients. Among treatment-naïve patients, clinical outcomes were similar for boceprevir and telaprevir, for SVR [odds ratio (OR) 0.90, 95% credible interval (95% CrI) 0.41-1.91] and for relapse (OR 1.09, 95% CrI 0.19-4.84). Similarly, among treatment-experienced patients, clinical outcomes were similar for boceprevir and telaprevir and for SVR (OR 1.45, 95% CrI 0.70-3.08) and for relapse (OR 0.35, 95% CrI 0.13-1.02). For treatment-naïve patients receiving standard-duration therapy, telaprevir yielded lower rates of anemia and neutropenia, but higher rates of rash and pruritus. For treatment-experience patients, all adverse event rates were higher with telaprevir.
Boceprevir and telaprevir exhibit similar effects among hepatitis C genotype 1 treatment-naïve and treatment-experienced patients. |
| doi_str_mv | 10.1093/qjmed/hcs214 |
| format | Article |
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To determine the relative efficacy of the new direct-acting antiviral agents by applying a multiple treatment comparison meta-analysis.
We included published Phase II and III randomized controlled trials evaluating head-to-head comparisons between boceprevir, telaprevir, peg-interferon alpha-2a with ribavirin and peg-interferon alpha-2b with ribavirin in hepatitis C genotype 1 patients. We applied Bayesian multiple treatment comparison meta-analysis.
We included data from four boceprevir, three telaprevir and six peg-interferon alpha-2a plus ribavirin vs. peg-interferon alpha-2b plus ribavirin randomized controlled trials. Both boceprevir and telaprevir offer statistically superior outcomes for SVR, relapse and discontinuation due to adverse events than either peg-interferons among both treatment-naïve and treatment-experienced patients. Among treatment-naïve patients, clinical outcomes were similar for boceprevir and telaprevir, for SVR [odds ratio (OR) 0.90, 95% credible interval (95% CrI) 0.41-1.91] and for relapse (OR 1.09, 95% CrI 0.19-4.84). Similarly, among treatment-experienced patients, clinical outcomes were similar for boceprevir and telaprevir and for SVR (OR 1.45, 95% CrI 0.70-3.08) and for relapse (OR 0.35, 95% CrI 0.13-1.02). For treatment-naïve patients receiving standard-duration therapy, telaprevir yielded lower rates of anemia and neutropenia, but higher rates of rash and pruritus. For treatment-experience patients, all adverse event rates were higher with telaprevir.
Boceprevir and telaprevir exhibit similar effects among hepatitis C genotype 1 treatment-naïve and treatment-experienced patients.</description><identifier>ISSN: 1460-2725</identifier><identifier>EISSN: 1460-2393</identifier><identifier>DOI: 10.1093/qjmed/hcs214</identifier><identifier>PMID: 23159839</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Anemia ; Antiviral agents ; Antiviral Agents - therapeutic use ; Bayesian analysis ; Clinical trials ; Clinical Trials, Phase II as Topic ; Clinical Trials, Phase III as Topic ; Comparative Effectiveness Research ; Data processing ; Drug Therapy, Combination ; Exanthema ; Female ; Genotypes ; Hepacivirus - genetics ; Hepacivirus - isolation & purification ; Hepatitis C ; Hepatitis C, Chronic - drug therapy ; Humans ; Infection ; Interferon-alpha - therapeutic use ; Male ; Neutropenia ; Oligopeptides - therapeutic use ; Original Papers ; Polyethylene Glycols - therapeutic use ; Proline - analogs & derivatives ; Proline - therapeutic use ; pruritus ; Randomized Controlled Trials as Topic ; Recombinant Proteins - therapeutic use ; Reviews ; Ribavirin ; Ribavirin - therapeutic use ; Treatment Outcome</subject><ispartof>QJM : An International Journal of Medicine, 2013-02, Vol.106 (2), p.153-163</ispartof><rights>The Author 2012. Published by Oxford University Press on behalf of the Association of Physicians. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-e48e76beb103d09d4ee604fe5008ae0af4cfb9cc9cd1f60d8027dab49c0947733</citedby><cites>FETCH-LOGICAL-c417t-e48e76beb103d09d4ee604fe5008ae0af4cfb9cc9cd1f60d8027dab49c0947733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23159839$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cooper, C</creatorcontrib><creatorcontrib>Lester, R</creatorcontrib><creatorcontrib>Thorlund, K</creatorcontrib><creatorcontrib>Druyts, E</creatorcontrib><creatorcontrib>El Khoury, A C</creatorcontrib><creatorcontrib>Yaya, S</creatorcontrib><creatorcontrib>Mills, E J</creatorcontrib><title>Direct-acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta-analysis</title><title>QJM : An International Journal of Medicine</title><addtitle>QJM</addtitle><description>New direct-acting antiviral agents for hepatitis C genotype 1 infection, boceprevir and telaprevir, offer enhanced sustained virologic response (SVR) among both treatment-naïve and treatment-experienced patients.
To determine the relative efficacy of the new direct-acting antiviral agents by applying a multiple treatment comparison meta-analysis.
We included published Phase II and III randomized controlled trials evaluating head-to-head comparisons between boceprevir, telaprevir, peg-interferon alpha-2a with ribavirin and peg-interferon alpha-2b with ribavirin in hepatitis C genotype 1 patients. We applied Bayesian multiple treatment comparison meta-analysis.
We included data from four boceprevir, three telaprevir and six peg-interferon alpha-2a plus ribavirin vs. peg-interferon alpha-2b plus ribavirin randomized controlled trials. Both boceprevir and telaprevir offer statistically superior outcomes for SVR, relapse and discontinuation due to adverse events than either peg-interferons among both treatment-naïve and treatment-experienced patients. Among treatment-naïve patients, clinical outcomes were similar for boceprevir and telaprevir, for SVR [odds ratio (OR) 0.90, 95% credible interval (95% CrI) 0.41-1.91] and for relapse (OR 1.09, 95% CrI 0.19-4.84). Similarly, among treatment-experienced patients, clinical outcomes were similar for boceprevir and telaprevir and for SVR (OR 1.45, 95% CrI 0.70-3.08) and for relapse (OR 0.35, 95% CrI 0.13-1.02). For treatment-naïve patients receiving standard-duration therapy, telaprevir yielded lower rates of anemia and neutropenia, but higher rates of rash and pruritus. For treatment-experience patients, all adverse event rates were higher with telaprevir.
Boceprevir and telaprevir exhibit similar effects among hepatitis C genotype 1 treatment-naïve and treatment-experienced patients.</description><subject>Anemia</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Bayesian analysis</subject><subject>Clinical trials</subject><subject>Clinical Trials, Phase II as Topic</subject><subject>Clinical Trials, Phase III as Topic</subject><subject>Comparative Effectiveness Research</subject><subject>Data processing</subject><subject>Drug Therapy, Combination</subject><subject>Exanthema</subject><subject>Female</subject><subject>Genotypes</subject><subject>Hepacivirus - genetics</subject><subject>Hepacivirus - isolation & purification</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Humans</subject><subject>Infection</subject><subject>Interferon-alpha - therapeutic use</subject><subject>Male</subject><subject>Neutropenia</subject><subject>Oligopeptides - therapeutic use</subject><subject>Original Papers</subject><subject>Polyethylene Glycols - therapeutic use</subject><subject>Proline - analogs & derivatives</subject><subject>Proline - therapeutic use</subject><subject>pruritus</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Recombinant Proteins - therapeutic use</subject><subject>Reviews</subject><subject>Ribavirin</subject><subject>Ribavirin - therapeutic use</subject><subject>Treatment Outcome</subject><issn>1460-2725</issn><issn>1460-2393</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1v1DAQtRCIloUbZ-QjB0LHsfNhDkhoKRSpUi_lbE2cya6rxE5tp9L-e9JuW9HTjDRv3rx5j7GPAr4K0PLs9mai_mxvUynUK3YqVA1FKbV8_dQ3ZXXC3qV0AwCqUe1bdlJKUelW6lO2_HSRbC7QZud3HH12dy7iyPOeIs6OEh9C5HuaMbvsEt_yHfmQDzNxwZ0f1mUX_DeOfFrG7OaReI6EeSKfuQ3TjNGl4PlEGQv0OB6SS-_ZmwHHRB8e64b9_XV-vb0oLq9-_9n-uCysEk0uSLXU1B11AmQPuldENaiBKoAWCXBQdui0tdr2Yqihb6FseuyUtqBV00i5Yd-PvPPSrS7ZVdP6m5mjmzAeTEBnXk6825tduDOyquDeoQ37_EgQw-1CKZvJJUvjiJ7CkoxYjaxF2Wi9Qr8coTaGlCINz2cEmPukzENS5pjUCv_0v7Rn8FM08h_wr5U8</recordid><startdate>20130201</startdate><enddate>20130201</enddate><creator>Cooper, C</creator><creator>Lester, R</creator><creator>Thorlund, K</creator><creator>Druyts, E</creator><creator>El Khoury, A C</creator><creator>Yaya, S</creator><creator>Mills, E J</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>20130201</creationdate><title>Direct-acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta-analysis</title><author>Cooper, C ; Lester, R ; Thorlund, K ; Druyts, E ; El Khoury, A C ; Yaya, S ; Mills, E J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-e48e76beb103d09d4ee604fe5008ae0af4cfb9cc9cd1f60d8027dab49c0947733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Anemia</topic><topic>Antiviral agents</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Bayesian analysis</topic><topic>Clinical trials</topic><topic>Clinical Trials, Phase II as Topic</topic><topic>Clinical Trials, Phase III as Topic</topic><topic>Comparative Effectiveness Research</topic><topic>Data processing</topic><topic>Drug Therapy, Combination</topic><topic>Exanthema</topic><topic>Female</topic><topic>Genotypes</topic><topic>Hepacivirus - genetics</topic><topic>Hepacivirus - isolation & purification</topic><topic>Hepatitis C</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Humans</topic><topic>Infection</topic><topic>Interferon-alpha - therapeutic use</topic><topic>Male</topic><topic>Neutropenia</topic><topic>Oligopeptides - therapeutic use</topic><topic>Original Papers</topic><topic>Polyethylene Glycols - therapeutic use</topic><topic>Proline - analogs & derivatives</topic><topic>Proline - therapeutic use</topic><topic>pruritus</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Recombinant Proteins - therapeutic use</topic><topic>Reviews</topic><topic>Ribavirin</topic><topic>Ribavirin - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cooper, C</creatorcontrib><creatorcontrib>Lester, R</creatorcontrib><creatorcontrib>Thorlund, K</creatorcontrib><creatorcontrib>Druyts, E</creatorcontrib><creatorcontrib>El Khoury, A C</creatorcontrib><creatorcontrib>Yaya, S</creatorcontrib><creatorcontrib>Mills, E J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>QJM : An International Journal of Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cooper, C</au><au>Lester, R</au><au>Thorlund, K</au><au>Druyts, E</au><au>El Khoury, A C</au><au>Yaya, S</au><au>Mills, E J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Direct-acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta-analysis</atitle><jtitle>QJM : An International Journal of Medicine</jtitle><addtitle>QJM</addtitle><date>2013-02-01</date><risdate>2013</risdate><volume>106</volume><issue>2</issue><spage>153</spage><epage>163</epage><pages>153-163</pages><issn>1460-2725</issn><eissn>1460-2393</eissn><abstract>New direct-acting antiviral agents for hepatitis C genotype 1 infection, boceprevir and telaprevir, offer enhanced sustained virologic response (SVR) among both treatment-naïve and treatment-experienced patients.
To determine the relative efficacy of the new direct-acting antiviral agents by applying a multiple treatment comparison meta-analysis.
We included published Phase II and III randomized controlled trials evaluating head-to-head comparisons between boceprevir, telaprevir, peg-interferon alpha-2a with ribavirin and peg-interferon alpha-2b with ribavirin in hepatitis C genotype 1 patients. We applied Bayesian multiple treatment comparison meta-analysis.
We included data from four boceprevir, three telaprevir and six peg-interferon alpha-2a plus ribavirin vs. peg-interferon alpha-2b plus ribavirin randomized controlled trials. Both boceprevir and telaprevir offer statistically superior outcomes for SVR, relapse and discontinuation due to adverse events than either peg-interferons among both treatment-naïve and treatment-experienced patients. Among treatment-naïve patients, clinical outcomes were similar for boceprevir and telaprevir, for SVR [odds ratio (OR) 0.90, 95% credible interval (95% CrI) 0.41-1.91] and for relapse (OR 1.09, 95% CrI 0.19-4.84). Similarly, among treatment-experienced patients, clinical outcomes were similar for boceprevir and telaprevir and for SVR (OR 1.45, 95% CrI 0.70-3.08) and for relapse (OR 0.35, 95% CrI 0.13-1.02). For treatment-naïve patients receiving standard-duration therapy, telaprevir yielded lower rates of anemia and neutropenia, but higher rates of rash and pruritus. For treatment-experience patients, all adverse event rates were higher with telaprevir.
Boceprevir and telaprevir exhibit similar effects among hepatitis C genotype 1 treatment-naïve and treatment-experienced patients.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>23159839</pmid><doi>10.1093/qjmed/hcs214</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anemia Antiviral agents Antiviral Agents - therapeutic use Bayesian analysis Clinical trials Clinical Trials, Phase II as Topic Clinical Trials, Phase III as Topic Comparative Effectiveness Research Data processing Drug Therapy, Combination Exanthema Female Genotypes Hepacivirus - genetics Hepacivirus - isolation & purification Hepatitis C Hepatitis C, Chronic - drug therapy Humans Infection Interferon-alpha - therapeutic use Male Neutropenia Oligopeptides - therapeutic use Original Papers Polyethylene Glycols - therapeutic use Proline - analogs & derivatives Proline - therapeutic use pruritus Randomized Controlled Trials as Topic Recombinant Proteins - therapeutic use Reviews Ribavirin Ribavirin - therapeutic use Treatment Outcome |
| title | Direct-acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta-analysis |
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