Digestive Diseases and Sciences

, Volume 56, Issue 8, pp 2221–2226

Peginterferon Alfa-2a Is Superior to Peginterferon Alfa-2b in the Treatment of Naïve Patients with Hepatitis C Virus Infection: Meta-Analysis of Randomized Controlled Trials

Authors

    • Department of Internal MedicineUniversity of Texas Medical Branch
    • Division of GastroenterologyUniversity of Texas Medical Branch
  • Sarat C. Jampana
    • Department of Internal MedicineUniversity of Texas Medical Branch
  • Bhupinderjit S. Anand
    • Department of Gastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical CenterBaylor College of Medicine
Original Article

DOI: 10.1007/s10620-011-1765-0

Cite this article as:
Singal, A.K., Jampana, S.C. & Anand, B.S. Dig Dis Sci (2011) 56: 2221. doi:10.1007/s10620-011-1765-0

Abstract

Background

Pegylated interferon (PEGIFN) and ribavirin combination is the standard of care for the treatment of chronic hepatitis C virus (HCV) infection. Studies comparing the efficacy and safety of PEGIFN alfa-2a and PEGIFN alfa-2b in treatment-naïve HCV-infected patients have shown conflicting results.

Aim

We performed a systematic review and meta-analysis of studies comparing the efficacy and safety of PEGIFN alfa-2a and PEGIFN alfa-2b in HCV-infected patients naïve to treatment.

Methods

Nine studies (five abstracts) with 3,546 patients (1,771 treated with PEGIFN alfa-2a) comparing PEGIFN alfa-2a and PEGIFN alfa-2b in treatment-naïve HCV patients were analyzed. Efficacy outcomes were sustained virologic response (SVR) and treatment discontinuation rates due to serious adverse effects (SAE).

Results

Pooled data on outcomes (reported as odds ratios [ORs] with 95% confidence intervals [CIs]: [OR (95% CI)]) showed higher SVR in patients treated with PEGIFN alfa-2a as compared to treatment with PEGIFN alfa-2b [1.36 (1.07–1.73); P = 0.01]. Subgroup analysis of good quality studies on SVR in genotypes 2 and 3 also favored PEGIFN alfa-2a over PEGIFN alfa-2b (1.91 [1.09–3.37]; P = 0.02). SVR results obtained with the two types of IFN showed no impact of viral load and the presence or absence of cirrhosis. Treatment discontinuation rates due to SAE, reported in six studies (two abstracts) on 3,211 patients (1,604 treated with PEGIFN alfa-2a), were similar in the two types of PEGIFN [0.66 (0.37–1.16); P = 0.15].

Conclusions

PEGIFN alfa-2a has superior efficacy with higher SVR as compared to PEGIFN alfa-2b in treatment-naïve HCV-infected patients. The safety profile of the two types of PEGIFN was similar.

Keywords

Hepatitis C virusHCVPegylated interferon alfa-2aPegylated interferon alfa-2bAntiviral therapyMeta-analysis

Copyright information

© Springer Science+Business Media, LLC 2011