Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients: an indirect comparison using Bayesian network meta-analysis
| Autor: | E.C. Jones, S. Cure, Joris Diels, F. Bianic, S. Gavart |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Genotype Proline Hepacivirus Pharmacology Antiviral Agents law.invention Telaprevir chemistry.chemical_compound Randomized controlled trial law Internal medicine Boceprevir medicine Credible interval Humans Randomized Controlled Trials as Topic business.industry Ribavirin virus diseases Bayes Theorem General Medicine Odds ratio Hepatitis C Chronic chemistry Meta-analysis Drug Therapy Combination business Oligopeptides medicine.drug |
| DOI: | 10.6084/m9.figshare.11816370 |
| Popis: | To indirectly compare the efficacy of telaprevir (TVR) and boceprevir (BOC) combined with peginterferon/ribavirin α-2a/2b (PR) in achieving sustained viral response (SVR) in treatment-naïve and treatment-experienced patients with genotype 1 chronic hepatitis C virus (HCV) infection. A systematic literature review was conducted to identify randomized controlled trials reporting the efficacy of PR-based treatment in genotype 1 chronic HCV patients. A Bayesian network meta-analysis was performed on the endpoint of SVR, assuming fixed study effects. For treatment-experienced patients, only previous relapsers and partial responders were included, as no results in prior null responders were available for boceprevir. Eleven publications were included. In treatment-naïve patients, the odds ratios (OR) (posterior median [95% credible interval]) for telaprevir (12 weeks + response guided treatment [RGT] 24/48 weeks PR) and boceprevir (24 weeks + RGT 28/48 weeks PR) versus PR were respectively 3.80 (2.78–5.22) and 2.99 (2.23–4.01). The OR for telaprevir versus boceprevir was 1.42 (0.89–2.25), with a probability for telaprevir being more effective (P[OR > 1]) of 0.93. In treatment-experienced patients, the OR of telaprevir (12 weeks + 48 weeks PR) and boceprevir (32 weeks + RGT 36/48 weeks PR) versus PR were respectively 13.11 (7.30–24.43) and 5.36 (2.90–10.30). The OR for telaprevir versus boceprevir was 2.45 (1.02–5.80), with telaprevir having a probability of 0.98 of being more effective. The main limitation of this study is the low number of trials included in the analysis, especially for the treatment-experienced patient population, which only allowed random-effect models to be explored. We tried to identify potential biases due to study heterogeneity. In the absence of direct comparative head-to-head studies between telaprevir and boceprevir for the treatment of chronic HCV genotype 1 patients, an indirect comparison based on Bayesian network meta-analysis suggests better efficacy for telaprevir than boceprevir in both treatment-naïve and treatment-experienced patients. |
| Databáze: | OpenAIRE |
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