Extended duration versus standard duration of peginterferon alfa-2a in treatment of chronic hepatitis B: A systematic review and meta-analysis

作者：Wang, Zhengyan; Sun, Ling; Wu, Yuwan; Xia, Qing^*

来源：Clinics and Research in Hepatology and Gastroenterology, 2016, 40(2): 195-202.

DOI：10.1016/j.clinre.2015.06.022

• LAMIVUDINE
• COMBINATION
• INTERFERON
• ENTECAVIR
• CIRRHOSIS
• THERAPY
• RISK

In the last decade, PEG-IFNa-2a has been widely used in the treatment of chronic hepatitis B (CHB). The current standard duration is 48 weeks; however, several studies based on small sample sizes have indicated that treatment extended beyond 48 weeks improved clinical outcomes than standard 48 weeks of therapy. Therefore, we performed a meta-analysis to compare the efficacy and safety of extended duration versus standard duration treatment with PEG-IFNa-2a monotherapy for patients with CHB. Four studies comprising of 350 patients were included in our study. Our analysis showed that extended treatment resulted in a higher HBsAg clearance rate compared with the standard treatment at the end of treatment, 24 and 48 weeks post-treatment [odds ratio (OR) = 2.45, 95% confidence intervals (CI) (1.17-5.11), P = 0.02; OR = 3.17, 95% CI (1.62-6.21), P < 0.01; OR = 5.02, 95% CI (1.63-15.45), P < 0.01, respectively]. Higher HBeAg seroconversion rates were also obtained in the extended treatment group than the standard treatment group at the end of treatment and 48 weeks post-treatment [OR = 2.09, 95% CI (1.10-3.98), P = 0.02, and OR = 2.67, 95% CI (1.39-5.13), P < 0.01, respectively]. In addition, extended treatment was superior to standard treatment in HBV-DNA inhibition rate at 48 weeks post-treatment [OR = 3.15, 95% CI (1.51-6.57), P < 0.01]. Therefore, extended treatment with PEG-IFNa-2a beyond 48 weeks may be a promising strategy to achieve higher rates of sustained HBV-DNA inhibition, HBeAg seroconversion and HBsAg clearance off-therapy for patients with CHB.

• 出版日期2016-4
• 单位四川大学