Combination therapy with pegylated interferon plus ribavirin is recommended for patients with chronic hepatitis C virus (HCV) infection who meet the criteria for treatment, but it is unclear whether pegylated interferon alfa-2a (Pegasys) or pegylated interferon alfa-2b (PegIntron) is more effective or associated with fewer adverse events.

Because there are few data from head-to-head trials of pegylated interferon regimens, researchers performed an adjusted indirect analysis of trials comparing dual therapy with Pegasys or PegIntron versus dual therapy with conventional (non-pegylated) interferon.

The researchers searched for potentially relevant randomized controlled trials using electronic databases and reference lists. A total of 16 trials met the inclusion criteria. Results of the analysis were published in the August 8, 2006 issue of the Journal of Viral Hepatitis.

Results

Based on these results, the study authors concluded, "There is insufficient evidence to support conclusions that dual therapy with one pegylated interferon is superior to the other."

They noted, however, "Because estimates are imprecise, our results also do not rule out a clinically significant difference. Head-to-head trials are needed to verify the results of indirect analyses and provide additional guidance on optimal treatment choices."

Oregon Evidence-based Practice Center, Oregon Health & Science University, Portland, OR.

7/18/08

Reference
R Chou, S Carson and BKS Chan. Pegylated interferons for chronic hepatitis C virus infection: an indirect analysis of randomized trials. Journal of Viral Hepatitis 15(8): 578-590. August 2008.