Interferon for non-A, non-B chronic hepatitis. A meta-analysis of randomised clinical trials.
We reviewed randomised clinical trials evaluating the effect of lymphoblastoid or recombinant alpha-interferon in non-A, non-B chronic hepatitis. The outcomes assessed were the rates of serum alanine aminotransferase normalization and relapse during and after stopping interferon. Data were pooled by meta-analysis and a 50% overall rate difference, favouring treated patients, was found. Results showed homogeneity in direction of treatment effect both after short-term (2-6 months, greater than or equal to 2 mega-units thrice weekly) and long-term (9-18 months, variable dose) interferon course. Moreover, results did not change when type of publication (abstracts vs. full reports) and treatment duration or schedule were accounted for. About 50% of patients originally responding to treatment relapsed within 6 months of either dose reduction or stopping interferon, thus suggesting that only in about one out of four patients is benefit from treatment sustained up to 1 year. We conclude that larger trials are needed to identify an optimal schedule of treatment and to evaluate predictors of interferon effectiveness in patients with non-A, non-B chronic hepatitis.
Tinè
F
F
Clinica Medica R of University of Palermo, Italy.
Magrin
S
S
Craxì
A
A
Pagliaro
L
L
D000410:Alanine Transaminase / Q000097:blood; D006525:Hepatitis, Viral, Human / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects / Q000627:therapeutic use*; D015201:Meta-Analysis as Topic; D011994:Recombinant Proteins
D007370:Interferon Type I; D011994:Recombinant Proteins; D000410:Alanine Transaminase