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Efficacy of Interferon-Free Therapies for Chronic Hepatitis C: A Systematic Review of All Randomized Clinical Trials

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Abstract

Background and Objectives

Second-generation direct-acting antivirals (DAAs) have recently arisen as more effective and safer treatments for chronic hepatitis C. These drugs can be combined into treatments without interferon (IFN), and are therefore called IFN-free therapies.

Objective

The objective of this study systematic review was to evaluate the efficacy of IFN-free therapies for the treatment of chronic hepatitis C, and thus increase the clinical evidence for these therapies.

Methods

A systematic review was conducted in accordance with Cochrane Collaboration recommendations. A search was performed in six different electronic databases using ‘clinical trials’, ‘hepatitis C’ and ‘interferon-free’ as the main descriptors, and studies that conformed to the inclusion criteria had their data extracted, including study information, baseline characteristics, and efficacy outcomes (sustained virologic response, rapid virologic response, and virologic failure).

Results

Sixty-four randomized clinical trials including 15 different therapies were included in a total of 15,731 patients infected with the hepatitis C virus, mostly with genotype 1, and mainly treated for 12 or 24 weeks. The sustained virologic response rate after 12 weeks of treatment was approximately 89%, while the virologic failure rate was below 5%.

Conclusions

Second-generation DAAs presented several advantages: virologic response values higher than the average achieved by previous IFN-based therapies, reduced treatment duration, and the possibility of different combinations of therapies to meet patient needs. Thus, IFN-free therapies appear to be valuable alternatives for the treatment of chronic hepatitis C.

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  1. Department of Pharmacy, Pharmaceutical Sciences Postgraduate Program, Universidade Federal do Paraná, Av. Pref. Lothario Meissner, 632, Jardim Botânico, Curitiba, PR, 80210170, Brazil

    Vinicius L. Ferreira, Fernanda S. Tonin, Nayara A. Assis Jarek, Yohanna Ramires & Roberto Pontarolo

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  1. Vinicius L. Ferreira
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  2. Fernanda S. Tonin
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  3. Nayara A. Assis Jarek
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  4. Yohanna Ramires
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  5. Roberto Pontarolo
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Correspondence to Vinicius L. Ferreira.

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Vinicius L. Ferreira, Fernanda S. Tonin, Nayara A. Assis Jarek, Yohanna Ramires and and Roberto Pontarolo declare no relevant conflicts of interest.

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Ferreira, V.L., Tonin, F.S., Assis Jarek, N.A. et al. Efficacy of Interferon-Free Therapies for Chronic Hepatitis C: A Systematic Review of All Randomized Clinical Trials. Clin Drug Investig 37, 635–646 (2017). https://doi.org/10.1007/s40261-017-0521-4

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