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Impact of all oral anti-hepatitis C virus therapy:A metaanalysis

World Journal of Hepatology 2015年第5期7卷 806-813页

作者： Siddharth Bansal Ashwani K Singal Brendan M Mc Guire Bhupinder S Anand Department of Internal Medicine University of Alabama Birmingham Department of Gastroenterology and Hepatology University of Alabama Birmingham Department of Gastroenterology and Hepatology Michael E.DeB akey VA Medical Center and Baylor College of Medicine

AIM:To investigate the efficacy,safety,and cost of treatment of direct acting antivirals(DAAs) with and without peg interferon alfa2a(P),and/or ribavirin(R) in treating hepatitis C virus(HCV) genotype 1 ***:MEDLINE was searched for randomized controlled trials(RCT) using DAAs for HCV *** 1 trials and studies with investigational drugs on genotype 2 or 3,and on human immunodeficiency virus patients were *** were pooled for sustained virologic response(SVR),serious adverse effects,and drug discontinuation rate on various treatment arms in trials:P + R;1st generation DAA(telaprevir or boceprevir) + P + R;2nd generation DAA(sofosbuvir or simeprevir) + P + R;2nd generation DAA + R;two 2nd generation DAA + R;and two 2nd gen *** were analyzed separately for each arm for treatment naive and non-responders(NR) to previous *** cost of treatment with each regimen for achieving one SVR was also ***:Twenty three RCTs(n = 9354,62% male,11% cirrhosis) were *** oral(P free) regimens with combination of 2 DAA achieved SVR above 95%.The cost of treatment to achieve an SVR with DAA based regimens was lower for NR compared to P+R ***,the cost per SVR remained higher for treatment naive ***:Second generation and emerging DAAs are promising agents in HCV treatment,with a very high level of safety and *** important drawback is their high ***,the present meta-analysis shows that the cost per SVR for non responders(but not for naive patients) was lower compared to P + *** finding together with the superior safety profile and better compliance makes these drugs highly *** is possible that further reduction in treatment duration may make them even more cost effective.

关键词： Hepatitis C Meta-analysis direct actingantivirals Oral agents Newer agents Hepatitis C virus

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