A Meta-Analysis of the Efficacy of Interferon Monotherapy or Combined with Different Nucleos(t)ide Analogues for Chronic Hepatitis B

Jialing Zhou, Xiaoning Wu, Wei Wei, Hong You, Jidong Jia and Yuanyuan Kong
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Jialing Zhou: Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Xiaoning Wu: Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Wei Wei: Clinical Epidemiology and Evidence-Based Medicine Unit, National Clinical Research Center for Digestive Diseases, Beijing 100050, China
Hong You: Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Jidong Jia: Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Yuanyuan Kong: Clinical Epidemiology and Evidence-Based Medicine Unit, National Clinical Research Center for Digestive Diseases, Beijing 100050, China

IJERPH, 2016, vol. 13, issue 7, 1-12

Abstract: Background: The aim of the present study was to compare the efficacy of interferon (IFN) with or without different nucleos(t)ide analogues (NAs). Methods: The PubMed, Wan Fang and CNKI databases were searched to identify relevant trials up to May 2015. Meta-analysis was performed with Review Manager 5.0. The stability and reliability were evaluated by publication bias tests. Results: Fifty-six studies fulfilled the criteria for the meta-analysis. Compared with IFN monotherapy, combination therapy were superior in HBV DNA undetectable rate (Risk Ratio (RR) = 1.55, 95% confidence interval (CI): 1.44–1.66, p < 0.00001), HBeAg and HBsAg loss rate (RR = 1.38, 95% CI: 1.22–1.56, p < 0.00001; RR = 1.69, 95% CI: 1.03–2.78, p = 0.04, respectively) at the end of week 48 treatment. Sub-analysis showed the RRs of virological response for entecavir (ETV), adefovir (ADV), and lamivudine (LAM) were 1.64, 1.61 and 1.52, respectively; RRs of HBeAg loss rate were 1.34, 1.71 and 1.34, respectively. However, at the end of follow-up, IFN plus NAs therapy was better than IFN monotherapy only in terms of HBV DNA undetectable rate ( p = 0.0007). Conclusions: Combination therapy was better than IFN monotherapy in virological and serological responses at the end of treatment. After follow-up, only HBV DNA undetectable rate was superior for combination therapy.

Keywords: chronic hepatitis B; nucleos(t)ide analogues; interferon; combination therapy; meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
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