 |
|
|
| |
THE EFFECT OF PEGINTERFERON ALFA-2A (40 KD) ON LIVER HISTOLOGY IN CHRONIC
HEPATITIS C: A META-ANALYSIS OF INDIVIDUAL PATIENTS DATA
|
| |
| |
C. Camma*, 1, 2 D. Di Bona, 1 F. Schepis, 3 E.J. Heathcote, 4 S. Zeuzem, 5
P.J. Pockros, 6 P. Marcellin, 7 A. Alberti, 8 A. Craxi, 1 *Presenting Author
1Cattedra Di Gastroenterologia, Istituto Di Clinica Medica, University Of
Palermo, Palermo, 2IBIM, Consiglio Nazionale Delle Ricerche, Palermo,
3Dipartimento Di Medicina Sperimentale E Clinica, University Of Magna
Graecia, Catanzaro, Italy 4Department Of Medicine, University Health Network,
Toronto Western Hospital, Toronto, Canada 5Klinikum Der Johann Wolfgang
Goethe University, Frankfurt, Germany 6Scripps Clinic, La Jolla, CA, USA
7INSERM U481, Service D'Hepatologie Hospital Beaujon, Clichy, France
8Dipartimento Di Medicina Clinica E Sperimentale, University Of Padova,
Padova, Italy
The benefit of peginterferon alfa-2a (40KD) on liver histology has been
extensively studied however, the results are still equivocal. Methods: We
performed a MIPD on 1013 naive patients with pre- and post-treatment biopsies
from 3 RCTs in order to assess the differences between peginterferon alfa-2a
(40KD) and interferon alfa-2a in liver histology, to determine if the
histological benefit of peginterferon alfa-2a is related to virological
response and to identify predictors of histological improvement. We used a
random-effects model to quantify the average effects of peginterferon alfa-2a
(40KD) on liver histology and identify predictors of fibrosis improvement by
logistic regression.
Results: Peginterferon alfa-2a (40KD) compared to interferon alfa-2a
significantly reduced fibrosis (net change -0.14; 95% confidence interval
[CI] from -0.27 to -0.01, p: 0.04). An impressive reduction in fibrosis after
treatment was observed in sustained virological responders (SVR) (-0.59; 95%
CI from -0.89 to -0.30;P<0.0001) and in relapsers (-0.34; 95% CI from -0.54
to -0.14;P: 00007), whereas no significant reduction was observed in
nonresponders (-0.13; 95% CI from -0.32 to +0.05;P: 0.15). By logistic
regression, fibrosis improvement was predicted independently by SVR (odds
ratio 1.52, 95% CI from 1.26 to 1.83) and by baseline body mass index (odds
ratio 1.34, 95% CI from 1.26 to 1.83). Regression of fibrosis was never
observed.
Conclusions: In patients with chronic hepatitis C with or without cirrhosis,
peginterferon alfa-2a (40KD) significantly improved fibrosis compared with
interferon alfa-2a. The benefit of peginterferon on liver histology is
closely related to virological response.
|
|
| |
|
|
|
|
|
