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. 2010 Spring;10(2):121-31.
Epub 2010 Jun 1.

The comparative efficacy and safety of peginterferon alpha-2a vs. 2b for the treatment of chronic HCV infection: a meta-analysis

Seyed Moayed Alavian  1 , Bita Behnava, Seyed Vahid Tabatabaei
Affiliations

The comparative efficacy and safety of peginterferon alpha-2a vs. 2b for the treatment of chronic HCV infection: a meta-analysis

Seyed Moayed Alavian et al. Hepat Mon. 2010 Spring.

Abstract

Background and aims: Two types of peginterferon, alpha-2a (PEG-IFN-α2a) and 2b (PEG-IFN-α2b), are approved for the treatment of hepatitis C infection. Several high-quality studies have compared the efficacy of these two types of interferon, but it seems that any of these trials had inadequate statistical power on their own to find even a tiny difference between these two medicines. We pooled the available data in the literature to find any small difference between these two medicines.

Methods: In a systematic review of the literature, randomized controlled trials comparing the use of PEG-α2a vs. 2b were assessed. The DerSimonian and Laird method was employed to run meta-analysis. The end points were virological responses.

Results: In 7 randomized controlled trials, 3518 patients were randomized to receive PEG-IFN-α2a + ribavirin (n=1762) or PEG-IFN-α2b + ribavirin (n=1756). Early virological response (EVR), early treatment response (ETR), and sustained virological response (SVR) were greater for patients treated with PEG-IFN-α2a. Odds Ratios (ORs) were 1.38 (95% confidence interval [CI] 1.11-1.71), 1.67 (95% CI 1.24-2.24), and 1.38 (95% CI 1.02-1.88) respectively. In the subset of naïve patients with genotype 1/4 and 2, ORs of SVR were 1.38 (95% CI 1.02-1.88) and 4.06 (95% CI 1.67-9.86) respectively. PEG-IFN-α2a had significantly higher rate of neutropenia OR=1.50 (95% CI 1.25-1.79) but pooled OR for withdrawal rates was not significant [OR=0.78 (95% CI 0.47-1.29)].

Conclusions: PEG-IFN-α2a with similar safety is more effective than PEG-IFN-α2b. A longer duration of maximum serum concentration compared with PEG-IFN-α2b (168 vs. 48-72 h.) yields a greater SVR and higher neutropenia in PEG-IFN-α2a recipients.

Keywords: HCV; Meta-Analysis; PegIntron; Pegasys; Peginterferon Alpha-2a; Peginterferon Alpha-2b; Systematic Review.

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Figures

Figure 1
Figure 1
Analysis of search results
Figure 2
Figure 2
Summary estimate of Odds ratios of achieving sustained virological response (SVR) with 95% CI in patients who were treated with peginterferon alpha-2a plus ribavirin versus those treated with peginterferon alpha-2b plus ribavirin
Figure 3
Figure 3
Summary estimate of Odds ratios of achieving early virological response (EVR) with 95% CI in patients who were treated with peginterferon alpha-2a plus ribavirin versus those treated with peginterferon alpha-2b plus ribavirin
Figure 4
Figure 4
Summary estimate of Odds ratios of achieving end of treatment virological response (ETR) with 95% CI in patients who were treated with peginterferon alpha-2a plus ribavirin versus those treated with peginterferon alpha-2b plus ribavirin
Figure 5
Figure 5
Summary estimate of Odds ratios of discontinuing the treatment with 95% CI in patients who were treated with peginterferon alpha-2a plus ribavirin versus those treated with peginterferon alpha-2b plus ribavirin
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