Meta-analysis: Interferon for the treatment of chronic hepatitis C in dialysis patients

F. Fabrizi, G. Dulai, V. Dixit, S. Bunnapradist, Paul Martin

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

Background: The efficacy of interferon monotherapy in dialysis patients with chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue. Methods and aims: We evaluated the efficacy and safety of initial interferon monotherapy in dialysis patients with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical trials. The primary outcome was sustained virological response (as a measure of efficacy); the secondary outcome was drop-out rate (as a measure of tolerability). We used the random effects model of Der Simonian and Laird, with heterogeneity and sensitivity analyses. Results: We have identified 14 clinical trials (269 unique patients); two were controlled studies. The mean overall estimate for sustained virological response (SVR) and drop-out rate was 37% [95% confidence interval (CI) 28-48] and 17% (95% CI 10-28), respectively. The most frequent side-effects requiring interruption of treatment were flu-like symptoms (17%), neurological (21%) and gastrointestinal (18%). The overall weighted estimate for SVR in patients with hepatitis C virus genotype 1 was 30.6% (95% CI 20.9-48). In the sub-group of clinical trials (n = 5) with standard interferon administration (3 million units [MUI] thrice weekly, subcutaneous route, 24-week treatment), the overall mean estimate of SVR was 39% (95% CI 25-56). The studies were heterogeneous with regard to SVR and drop-out rate. Conclusions: Tolerance to initial interferon monotherapy was lower in dialysis than nonuremic patients with chronic hepatitis C. However, more than one-third of haemodialysis patients with chronic hepatitis C have been successfully treated with interferon. Longer duration of interferon monotherapy does not appear to have a beneficial effect on the response rate. Further studies are warranted to define the optimal anti-viral regimen for chronic hepatitis C in dialysis population.

Original languageEnglish
Pages (from-to)1071-1081
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume18
Issue number11-12
DOIs
StatePublished - Dec 1 2003
Externally publishedYes

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Chronic Hepatitis C
Interferons
Meta-Analysis
Dialysis
Clinical Trials
Confidence Intervals
Therapeutics
Hepacivirus
Renal Dialysis
Genotype
Safety
Population

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Meta-analysis : Interferon for the treatment of chronic hepatitis C in dialysis patients. / Fabrizi, F.; Dulai, G.; Dixit, V.; Bunnapradist, S.; Martin, Paul.

In: Alimentary Pharmacology and Therapeutics, Vol. 18, No. 11-12, 01.12.2003, p. 1071-1081.

Research output: Contribution to journalArticle

Fabrizi, F. ; Dulai, G. ; Dixit, V. ; Bunnapradist, S. ; Martin, Paul. / Meta-analysis : Interferon for the treatment of chronic hepatitis C in dialysis patients. In: Alimentary Pharmacology and Therapeutics. 2003 ; Vol. 18, No. 11-12. pp. 1071-1081.
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