Efficacy of interferon-based therapy in the treatment of thalassaemic patients with chronic hepatitis C: a meta-analysis.
OBJECTIVE
To identify the interferon-alpha (IFNalpha) treatment protocol most suitable for patients with thalassaemia major who have chronic hepatitis C.


METHODS
This was a meta-analysis of studies in the international literature between 1990 and 1999.


METHODS
Studies were identified from a search of Medline and Embase, and analysed by the Mantel-Haenszel-Peto statistical method.


RESULTS
We identified 6 nonrandomised trials, 2 of which were controlled, that treated a total of 201 patients. Most studies used the lowest dose level (3 MIU/m(2)), all used a thrice-weekly regimen, and most used IFNalpha-2b, although the use of natural IFNalpha did not induce production of anti-interferon antibodies. The best sustained response and remission rates tended to be achieved with higher doses and longer cycles of IFNalpha.


CONCLUSIONS
The best interferon-based therapy to treat polytransfused thalassaemic patients with chronic hepatitis C is represented by the use of natural IFNalpha or IFNalpha-2b, initially at high dosages (5 to 10 MIU/m(2) 3 times weekly) for 6 months, followed by lower dosages (3 MIU/m(2) 3 times weekly) for a further 6 to 9 months.
Institute of Internal Medicine and Geriatrics, University of Catania, Italy.
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G
Pistone
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MC
Bertolini
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M
Malaguarnera
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S
Musumeci