A comparative network meta-analysis of standard of care treatments in treatment-naive chronic hepatitis B patients
| Jazyk: | angličtina |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
POSITIVE CHRONIC HEPATITIS
TENOFOVIR DISOPROXIL FUMARATE ANTIVIRAL TREATMENT PEGINTERFERON ALPHA-2A gastroenterology ADEFOVIR DIPIVOXIL infectious diseases OPEN-LABEL meta-analysis DOUBLE-BLIND COMBINATION THERAPY systematic review comparative effectiveness research hepatology E-ANTIGEN PEGYLATED INTERFERON-ALPHA-2B |
| Zdroj: | Journal of Comparative Effectiveness Research. 9(15):1051-1065 |
| ISSN: | 2042-6313 2042-6305 |
| DOI: | 10.2217/cer-2020-0068 |
| Popis: | Objective:Published network meta-analyses of chronic hepatitis B (CHB) treatments are either out-of-date or excluded key treatments. Therefore, we aimed to comprehensively update the efficacy evidence for the following end points: Hepatitis B surface antigen (HBsAg) loss, hepatitis B early antigen (HBeAg) seroconversion and hepatitis B virus DNA (HBV DNA) suppression.Materials & methods:Approved treatments in CHB and their combinations were evaluated. A systematic literature review was conducted to identify all randomized controlled trials in treatment-naive CHB patients. Included studies reported at least one of the end points of interest. A frequentist probability network meta-analysis was performed for each end point. The choice of fixed effect or random-effect model was based on the I-square statistic, a measure of variation in study outcomes between studies. The analyses were performed separately for HBeAg-positive and HBeAg-negative patients. For the primary analyses, end points measured 48 +/- 4 weeks after treatment initiation were considered.Results:A total of 47 randomized controlled trials (13,826 patients), covering 23 unique treatment regimens, were included: a total of 29 reported HBsAg loss, 36 reported HBeAg seroconversion and 37 reported HBV DNA suppression. For both HBsAg loss and HBeAg seroconversion, pegylated interferon-based regimens were the most effective strategy in both HBeAg-positive and HBeAg-negative patients. On the other hand, for HBV DNA suppression, nucleosides-based regimens were the most effective strategy in both HBeAg-positive and HBeAg-negative patients.Conclusion:Our findings confirm available evidence around the comparative efficacy of available CHB treatments. Therefore, they can be used to update relevant cost-effectiveness analyses and clinical guidelines. |
| Databáze: | OpenAIRE |
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