Long-term effect of interferon treatment on the progression of chronic hepatitis B: Bayesian meta-analysis and meta-regression

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2011.00801.x/abstract

Long-term effect of interferon treatment on the progression of chronic hepatitis

B: Bayesian meta-analysis and meta-regression

Hui Jin1, Ning Pan2, Yi Mou3, Bei Wang1, Pei Liu1,*Article first published

online: 19 APR 2011

DOI: 10.1111/j.1872-034X.2011.00801.x

© 2011 The Japan Society of Hepatology

Issue

Hepatology Research

Volume 41, Issue 6, pages 512–523, June 2011

Abstract

Aim:  The long-term effects of interferon treatment on the progression of

chronic hepatitis B (CHB) have been studied extensively, but its true clinical

benefits and the predictors of its efficacy remain unclear.

Methods:  A systematic published work search was undertaken. Eligible studies

included those with interferon treatment and control groups, and with liver

cirrhosis (LC), hepatocellular carcinoma (HCC) or death as main outcomes.

Bayesian meta-analysis and meta-regression were performed to assess associations

between interferon treatment and disease progression, and the impacts of

potential covariates.

Results:  Eleven articles met the inclusion criteria. LC, HCC and death were

end-points in four, nine and six studies, respectively. In all studies,

interferon was associated with significant preventive effects on HCC according

to the DerSimonian–Laird method (relative risk [RR] = 0.470, 95% confidence

interval [CI] = 0.260–0.850) and Bayesian method adjusting underlying risk (RR

= 0.249, 95% Bayesian credible intervals [bCI] = 0.049–0.961), but not

according to Bayesian meta-analysis (RR = 0.274, 95% BCI = 0.059–1.031); and

it showed similar effects in death but not in LC. However, most of the

high-quality studies never revealed protective benefits in these end-points.

Bayesian meta-regression identified Asian ethnicity in death, higher hepatitis B

e-antigen (HBeAg) seroconversion rate or positivity rate, and length of follow

up (≤5 years) in HCC as potentially protective against disease progression.

Subgroup analysis confirmed similar effects from these factors in HCC and death.

Conclusion:  Additional evidence is needed to support the role of interferon

in delaying CHB progression.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2011.00801.x/abstract

Long-term effect of interferon treatment on the progression of chronic hepatitis

B: Bayesian meta-analysis and meta-regression

Hui Jin1, Ning Pan2, Yi Mou3, Bei Wang1, Pei Liu1,*Article first published

online: 19 APR 2011

DOI: 10.1111/j.1872-034X.2011.00801.x

© 2011 The Japan Society of Hepatology

Issue

Hepatology Research

Volume 41, Issue 6, pages 512–523, June 2011

Abstract

Aim:  The long-term effects of interferon treatment on the progression of

chronic hepatitis B (CHB) have been studied extensively, but its true clinical

benefits and the predictors of its efficacy remain unclear.

Methods:  A systematic published work search was undertaken. Eligible studies

included those with interferon treatment and control groups, and with liver

cirrhosis (LC), hepatocellular carcinoma (HCC) or death as main outcomes.

Bayesian meta-analysis and meta-regression were performed to assess associations

between interferon treatment and disease progression, and the impacts of

potential covariates.

Results:  Eleven articles met the inclusion criteria. LC, HCC and death were

end-points in four, nine and six studies, respectively. In all studies,

interferon was associated with significant preventive effects on HCC according

to the DerSimonian–Laird method (relative risk [RR] = 0.470, 95% confidence

interval [CI] = 0.260–0.850) and Bayesian method adjusting underlying risk (RR

= 0.249, 95% Bayesian credible intervals [bCI] = 0.049–0.961), but not

according to Bayesian meta-analysis (RR = 0.274, 95% BCI = 0.059–1.031); and

it showed similar effects in death but not in LC. However, most of the

high-quality studies never revealed protective benefits in these end-points.

Bayesian meta-regression identified Asian ethnicity in death, higher hepatitis B

e-antigen (HBeAg) seroconversion rate or positivity rate, and length of follow

up (≤5 years) in HCC as potentially protective against disease progression.

Subgroup analysis confirmed similar effects from these factors in HCC and death.

Conclusion:  Additional evidence is needed to support the role of interferon

in delaying CHB progression.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2011.00801.x/abstract

Long-term effect of interferon treatment on the progression of chronic hepatitis

B: Bayesian meta-analysis and meta-regression

Hui Jin1, Ning Pan2, Yi Mou3, Bei Wang1, Pei Liu1,*Article first published

online: 19 APR 2011

DOI: 10.1111/j.1872-034X.2011.00801.x

© 2011 The Japan Society of Hepatology

Issue

Hepatology Research

Volume 41, Issue 6, pages 512–523, June 2011

Abstract

Aim:  The long-term effects of interferon treatment on the progression of

chronic hepatitis B (CHB) have been studied extensively, but its true clinical

benefits and the predictors of its efficacy remain unclear.

Methods:  A systematic published work search was undertaken. Eligible studies

included those with interferon treatment and control groups, and with liver

cirrhosis (LC), hepatocellular carcinoma (HCC) or death as main outcomes.

Bayesian meta-analysis and meta-regression were performed to assess associations

between interferon treatment and disease progression, and the impacts of

potential covariates.

Results:  Eleven articles met the inclusion criteria. LC, HCC and death were

end-points in four, nine and six studies, respectively. In all studies,

interferon was associated with significant preventive effects on HCC according

to the DerSimonian–Laird method (relative risk [RR] = 0.470, 95% confidence

interval [CI] = 0.260–0.850) and Bayesian method adjusting underlying risk (RR

= 0.249, 95% Bayesian credible intervals [bCI] = 0.049–0.961), but not

according to Bayesian meta-analysis (RR = 0.274, 95% BCI = 0.059–1.031); and

it showed similar effects in death but not in LC. However, most of the

high-quality studies never revealed protective benefits in these end-points.

Bayesian meta-regression identified Asian ethnicity in death, higher hepatitis B

e-antigen (HBeAg) seroconversion rate or positivity rate, and length of follow

up (≤5 years) in HCC as potentially protective against disease progression.

Subgroup analysis confirmed similar effects from these factors in HCC and death.

Conclusion:  Additional evidence is needed to support the role of interferon

in delaying CHB progression.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1872-034X.2011.00801.x/abstract

Long-term effect of interferon treatment on the progression of chronic hepatitis

B: Bayesian meta-analysis and meta-regression

Hui Jin1, Ning Pan2, Yi Mou3, Bei Wang1, Pei Liu1,*Article first published

online: 19 APR 2011

DOI: 10.1111/j.1872-034X.2011.00801.x

© 2011 The Japan Society of Hepatology

Issue

Hepatology Research

Volume 41, Issue 6, pages 512–523, June 2011

Abstract

Aim:  The long-term effects of interferon treatment on the progression of

chronic hepatitis B (CHB) have been studied extensively, but its true clinical

benefits and the predictors of its efficacy remain unclear.

Methods:  A systematic published work search was undertaken. Eligible studies

included those with interferon treatment and control groups, and with liver

cirrhosis (LC), hepatocellular carcinoma (HCC) or death as main outcomes.

Bayesian meta-analysis and meta-regression were performed to assess associations

between interferon treatment and disease progression, and the impacts of

potential covariates.

Results:  Eleven articles met the inclusion criteria. LC, HCC and death were

end-points in four, nine and six studies, respectively. In all studies,

interferon was associated with significant preventive effects on HCC according

to the DerSimonian–Laird method (relative risk [RR] = 0.470, 95% confidence

interval [CI] = 0.260–0.850) and Bayesian method adjusting underlying risk (RR

= 0.249, 95% Bayesian credible intervals [bCI] = 0.049–0.961), but not

according to Bayesian meta-analysis (RR = 0.274, 95% BCI = 0.059–1.031); and

it showed similar effects in death but not in LC. However, most of the

high-quality studies never revealed protective benefits in these end-points.

Bayesian meta-regression identified Asian ethnicity in death, higher hepatitis B

e-antigen (HBeAg) seroconversion rate or positivity rate, and length of follow

up (≤5 years) in HCC as potentially protective against disease progression.

Subgroup analysis confirmed similar effects from these factors in HCC and death.

Conclusion:  Additional evidence is needed to support the role of interferon

in delaying CHB progression.