Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg clearance or seroconversion: a meta-analysis of controlled clinical trials

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Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg

clearance or seroconversion: a meta-analysis of controlled clinical trials

Interferon alpha (IFNalpha) therapy has been widely used in the treatment of

chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also

increasingly used to treat CHB recently.

More and more studies are being carried out concerning the clearance or

seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy.

This study conducted a meta-analysis to estimate the effect of pegylated

interferon alpha (peginterferon alpha, PEG-IFNalpha)-based therapy on HBsAg

clearance or seroconversion in CHB.

Methods: All available controlled clinical trials, published from 2004 to 2010,

with the following antiviral therapies for CHB patients: PEG-IFNalpha combined

with lamivudine (LAM), PEG-IFNalpha only, conventional IFNalpha and LAM, with a

course [greater than or equal to]24 weeks, were meta-analysed for HBsAg

clearance and seroconversion.

Results: Fourteen trials (involving a total of 2,682 patients) were identified,

including seven high-quality and seven low-quality studies.

The analysis results of the different antiviral therapies on HBsAg clearance or

seroconversion were as follows:

1. No significant difference in HBsAg clearance or seroconversion was observed

between the combination therapy group and PEG-IFNalpha monotherapy group [odds

ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), P = 0.54 and OR =

1.07, 95% CI (0.58-1.97), P = 0.82, respectively];

2.HBsAg clearance and seroconversion rates in patients with combination therapy

were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI

(1.18-74.94), P = 0.03, and OR = 12.37, 95% CI (1.60-95.44), P = 0.02,

respectively];

3. There was significant difference in HBsAg clearance between the PEG-IFNalpha

group and IFNalpha monotherapy group [OR = 4.95, 95% CI (1.23-20.00), P = 0.02],

but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), P = 0.37];

4.PEG-IFNalpha was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI

(1.91-111.49), P = 0.01].

Conclusions: PEG-IFNalpha facilitated HBsAg clearance or seroconversion in CHB

patients. PEG-IFNalpha-based therapy was more effective than LAM monotherapy in

achieving HBsAg clearance or seroconversion for both HBeAg-positive and

HBeAg-negative CHB patients.

There was no significant difference in HBsAg clearance or seroconversion between

PEG-IFNalpha/LAM combination therapy and PEG-IFNalpha monotherapy. PEG-IFNalpha

was obviously superior to conventional IFNalpha in HBsAg clearance, but not in

HBsAg seroconversion.

Although PEG-IFNalpha produced significantly higher rates of HBsAg clearance and

seroconversion, the absolute change in the proportion ofHBsAg clearance and

seroconversion was low (about 3-6%). Therefore, additional interventions are

needed to improve the rate of positive outcomes.

Author: Wen-cong LiMao-rong WangLing-bo KongWei-guang RenYu-guo ZhangYue-min Nan

Credits/Source: BMC Infectious Diseases 2011, 11:165

[Guest guest]

http://7thspace.com/headlines/385498/peginterferon_alpha_based_therapy_for_chron\

ic_hepatitis_b_focusing_on_hbsag_clearance_or_seroconversion_a_meta_analysis_of_\

controlled_clinical_trials.html

Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg

clearance or seroconversion: a meta-analysis of controlled clinical trials

Interferon alpha (IFNalpha) therapy has been widely used in the treatment of

chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also

increasingly used to treat CHB recently.

More and more studies are being carried out concerning the clearance or

seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy.

This study conducted a meta-analysis to estimate the effect of pegylated

interferon alpha (peginterferon alpha, PEG-IFNalpha)-based therapy on HBsAg

clearance or seroconversion in CHB.

Methods: All available controlled clinical trials, published from 2004 to 2010,

with the following antiviral therapies for CHB patients: PEG-IFNalpha combined

with lamivudine (LAM), PEG-IFNalpha only, conventional IFNalpha and LAM, with a

course [greater than or equal to]24 weeks, were meta-analysed for HBsAg

clearance and seroconversion.

Results: Fourteen trials (involving a total of 2,682 patients) were identified,

including seven high-quality and seven low-quality studies.

The analysis results of the different antiviral therapies on HBsAg clearance or

seroconversion were as follows:

1. No significant difference in HBsAg clearance or seroconversion was observed

between the combination therapy group and PEG-IFNalpha monotherapy group [odds

ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), P = 0.54 and OR =

1.07, 95% CI (0.58-1.97), P = 0.82, respectively];

2.HBsAg clearance and seroconversion rates in patients with combination therapy

were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI

(1.18-74.94), P = 0.03, and OR = 12.37, 95% CI (1.60-95.44), P = 0.02,

respectively];

3. There was significant difference in HBsAg clearance between the PEG-IFNalpha

group and IFNalpha monotherapy group [OR = 4.95, 95% CI (1.23-20.00), P = 0.02],

but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), P = 0.37];

4.PEG-IFNalpha was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI

(1.91-111.49), P = 0.01].

Conclusions: PEG-IFNalpha facilitated HBsAg clearance or seroconversion in CHB

patients. PEG-IFNalpha-based therapy was more effective than LAM monotherapy in

achieving HBsAg clearance or seroconversion for both HBeAg-positive and

HBeAg-negative CHB patients.

There was no significant difference in HBsAg clearance or seroconversion between

PEG-IFNalpha/LAM combination therapy and PEG-IFNalpha monotherapy. PEG-IFNalpha

was obviously superior to conventional IFNalpha in HBsAg clearance, but not in

HBsAg seroconversion.

Although PEG-IFNalpha produced significantly higher rates of HBsAg clearance and

seroconversion, the absolute change in the proportion ofHBsAg clearance and

seroconversion was low (about 3-6%). Therefore, additional interventions are

needed to improve the rate of positive outcomes.

Author: Wen-cong LiMao-rong WangLing-bo KongWei-guang RenYu-guo ZhangYue-min Nan

Credits/Source: BMC Infectious Diseases 2011, 11:165

[Guest guest]

http://7thspace.com/headlines/385498/peginterferon_alpha_based_therapy_for_chron\

ic_hepatitis_b_focusing_on_hbsag_clearance_or_seroconversion_a_meta_analysis_of_\

controlled_clinical_trials.html

Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg

clearance or seroconversion: a meta-analysis of controlled clinical trials

Interferon alpha (IFNalpha) therapy has been widely used in the treatment of

chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also

increasingly used to treat CHB recently.

More and more studies are being carried out concerning the clearance or

seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy.

This study conducted a meta-analysis to estimate the effect of pegylated

interferon alpha (peginterferon alpha, PEG-IFNalpha)-based therapy on HBsAg

clearance or seroconversion in CHB.

Methods: All available controlled clinical trials, published from 2004 to 2010,

with the following antiviral therapies for CHB patients: PEG-IFNalpha combined

with lamivudine (LAM), PEG-IFNalpha only, conventional IFNalpha and LAM, with a

course [greater than or equal to]24 weeks, were meta-analysed for HBsAg

clearance and seroconversion.

Results: Fourteen trials (involving a total of 2,682 patients) were identified,

including seven high-quality and seven low-quality studies.

The analysis results of the different antiviral therapies on HBsAg clearance or

seroconversion were as follows:

1. No significant difference in HBsAg clearance or seroconversion was observed

between the combination therapy group and PEG-IFNalpha monotherapy group [odds

ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), P = 0.54 and OR =

1.07, 95% CI (0.58-1.97), P = 0.82, respectively];

2.HBsAg clearance and seroconversion rates in patients with combination therapy

were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI

(1.18-74.94), P = 0.03, and OR = 12.37, 95% CI (1.60-95.44), P = 0.02,

respectively];

3. There was significant difference in HBsAg clearance between the PEG-IFNalpha

group and IFNalpha monotherapy group [OR = 4.95, 95% CI (1.23-20.00), P = 0.02],

but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), P = 0.37];

4.PEG-IFNalpha was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI

(1.91-111.49), P = 0.01].

Conclusions: PEG-IFNalpha facilitated HBsAg clearance or seroconversion in CHB

patients. PEG-IFNalpha-based therapy was more effective than LAM monotherapy in

achieving HBsAg clearance or seroconversion for both HBeAg-positive and

HBeAg-negative CHB patients.

There was no significant difference in HBsAg clearance or seroconversion between

PEG-IFNalpha/LAM combination therapy and PEG-IFNalpha monotherapy. PEG-IFNalpha

was obviously superior to conventional IFNalpha in HBsAg clearance, but not in

HBsAg seroconversion.

Although PEG-IFNalpha produced significantly higher rates of HBsAg clearance and

seroconversion, the absolute change in the proportion ofHBsAg clearance and

seroconversion was low (about 3-6%). Therefore, additional interventions are

needed to improve the rate of positive outcomes.

Author: Wen-cong LiMao-rong WangLing-bo KongWei-guang RenYu-guo ZhangYue-min Nan

Credits/Source: BMC Infectious Diseases 2011, 11:165

[Guest guest]

http://7thspace.com/headlines/385498/peginterferon_alpha_based_therapy_for_chron\

ic_hepatitis_b_focusing_on_hbsag_clearance_or_seroconversion_a_meta_analysis_of_\

controlled_clinical_trials.html

Peginterferon alpha-based therapy for chronic hepatitis B focusing on HBsAg

clearance or seroconversion: a meta-analysis of controlled clinical trials

Interferon alpha (IFNalpha) therapy has been widely used in the treatment of

chronic hepatitis B (CHB) for decades. Nucleos(t)ide analogues are also

increasingly used to treat CHB recently.

More and more studies are being carried out concerning the clearance or

seroconversion of HBsAg, which is recognized as an ideal goal of CHB therapy.

This study conducted a meta-analysis to estimate the effect of pegylated

interferon alpha (peginterferon alpha, PEG-IFNalpha)-based therapy on HBsAg

clearance or seroconversion in CHB.

Methods: All available controlled clinical trials, published from 2004 to 2010,

with the following antiviral therapies for CHB patients: PEG-IFNalpha combined

with lamivudine (LAM), PEG-IFNalpha only, conventional IFNalpha and LAM, with a

course [greater than or equal to]24 weeks, were meta-analysed for HBsAg

clearance and seroconversion.

Results: Fourteen trials (involving a total of 2,682 patients) were identified,

including seven high-quality and seven low-quality studies.

The analysis results of the different antiviral therapies on HBsAg clearance or

seroconversion were as follows:

1. No significant difference in HBsAg clearance or seroconversion was observed

between the combination therapy group and PEG-IFNalpha monotherapy group [odds

ratio (OR) = 1.16, 95% confidence intervals (CI) (0.73-1.85), P = 0.54 and OR =

1.07, 95% CI (0.58-1.97), P = 0.82, respectively];

2.HBsAg clearance and seroconversion rates in patients with combination therapy

were markedly higher than in those with LAM monotherapy [OR = 9.41, 95% CI

(1.18-74.94), P = 0.03, and OR = 12.37, 95% CI (1.60-95.44), P = 0.02,

respectively];

3. There was significant difference in HBsAg clearance between the PEG-IFNalpha

group and IFNalpha monotherapy group [OR = 4.95, 95% CI (1.23-20.00), P = 0.02],

but not in seroconversion [OR = 2.44, 95% CI (0.35-17.08), P = 0.37];

4.PEG-IFNalpha was superior to LAM in HBsAg seroconversion [OR = 14.59, 95% CI

(1.91-111.49), P = 0.01].

Conclusions: PEG-IFNalpha facilitated HBsAg clearance or seroconversion in CHB

patients. PEG-IFNalpha-based therapy was more effective than LAM monotherapy in

achieving HBsAg clearance or seroconversion for both HBeAg-positive and

HBeAg-negative CHB patients.

There was no significant difference in HBsAg clearance or seroconversion between

PEG-IFNalpha/LAM combination therapy and PEG-IFNalpha monotherapy. PEG-IFNalpha

was obviously superior to conventional IFNalpha in HBsAg clearance, but not in

HBsAg seroconversion.

Although PEG-IFNalpha produced significantly higher rates of HBsAg clearance and

seroconversion, the absolute change in the proportion ofHBsAg clearance and

seroconversion was low (about 3-6%). Therefore, additional interventions are

needed to improve the rate of positive outcomes.

Author: Wen-cong LiMao-rong WangLing-bo KongWei-guang RenYu-guo ZhangYue-min Nan

Credits/Source: BMC Infectious Diseases 2011, 11:165