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Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis
WHAT IS KNOWN AND OBJECTIVE: Sofosbuvir (SOF) is a new and highly effective medication that dramatically improved hepatitis C virus (HCV) management. However, ribavirin (RBV) is still added to SOF‐based medication regimens in several clinical scenarios, despite its well‐known toxicities. The aim of...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545628/ https://www.ncbi.nlm.nih.gov/pubmed/35678040 http://dx.doi.org/10.1111/jcpt.13698 |
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author | Elshafie, Shaimaa Trivedi‐Kapoor, Rupal Ebell, Mark |
author_facet | Elshafie, Shaimaa Trivedi‐Kapoor, Rupal Ebell, Mark |
author_sort | Elshafie, Shaimaa |
collection | PubMed |
description | WHAT IS KNOWN AND OBJECTIVE: Sofosbuvir (SOF) is a new and highly effective medication that dramatically improved hepatitis C virus (HCV) management. However, ribavirin (RBV) is still added to SOF‐based medication regimens in several clinical scenarios, despite its well‐known toxicities. The aim of our study is to systematically review and analyse the impact of adding RBV to SOF‐based medication regimens on clinical outcomes among HCV patients. METHODS: Included studies were randomized trials comparing the same SOF‐based medication regimens with and without RBV in HCV patients and measuring serious adverse events (SAEs) and/or sustained virologic response at 12 weeks post‐treatment (SVR‐12). Two investigators independently searched PubMed and Cochrane Library through September 2021. The Cochrane Risk of Bias tool was used to assess trials quality. Clinical outcomes were analysed as risk ratios (RR) using a random effects model using R version 4.1.2. RESULTS AND DISCUSSION: Our study included a total of 26 trials with 5058 HCV patients. Quality assessment showed moderate risk of bias for most trials. Upon adding RBV, there was no significant difference in SAEs (RR 1.07, 95% CI: 0.77–1.48, I (2) = 10%), nor an impact on SVR‐12 (RR 1.00, 95% CI: 0.98–1.01, I (2) = 41%). There was no evidence of publication bias for either outcome. Subgroup analysis consistently showed lack of benefit among HCV subgroups. Additionally, NCT01826981 was identified as the main source of heterogeneity in the SVR‐12 outcome. WHAT IS NEW AND CONCLUSION: Our findings suggest nonsignificant differences in safety and efficacy between SOF‐based medication regimens with and without RBV which should be considered in clinical practice. |
format | Online Article Text |
id | pubmed-9545628 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95456282022-10-14 Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis Elshafie, Shaimaa Trivedi‐Kapoor, Rupal Ebell, Mark J Clin Pharm Ther Review Articles WHAT IS KNOWN AND OBJECTIVE: Sofosbuvir (SOF) is a new and highly effective medication that dramatically improved hepatitis C virus (HCV) management. However, ribavirin (RBV) is still added to SOF‐based medication regimens in several clinical scenarios, despite its well‐known toxicities. The aim of our study is to systematically review and analyse the impact of adding RBV to SOF‐based medication regimens on clinical outcomes among HCV patients. METHODS: Included studies were randomized trials comparing the same SOF‐based medication regimens with and without RBV in HCV patients and measuring serious adverse events (SAEs) and/or sustained virologic response at 12 weeks post‐treatment (SVR‐12). Two investigators independently searched PubMed and Cochrane Library through September 2021. The Cochrane Risk of Bias tool was used to assess trials quality. Clinical outcomes were analysed as risk ratios (RR) using a random effects model using R version 4.1.2. RESULTS AND DISCUSSION: Our study included a total of 26 trials with 5058 HCV patients. Quality assessment showed moderate risk of bias for most trials. Upon adding RBV, there was no significant difference in SAEs (RR 1.07, 95% CI: 0.77–1.48, I (2) = 10%), nor an impact on SVR‐12 (RR 1.00, 95% CI: 0.98–1.01, I (2) = 41%). There was no evidence of publication bias for either outcome. Subgroup analysis consistently showed lack of benefit among HCV subgroups. Additionally, NCT01826981 was identified as the main source of heterogeneity in the SVR‐12 outcome. WHAT IS NEW AND CONCLUSION: Our findings suggest nonsignificant differences in safety and efficacy between SOF‐based medication regimens with and without RBV which should be considered in clinical practice. John Wiley and Sons Inc. 2022-06-08 2022-08 /pmc/articles/PMC9545628/ /pubmed/35678040 http://dx.doi.org/10.1111/jcpt.13698 Text en © 2022 The Authors. Journal of Clinical Pharmacy and Therapeutics published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Review Articles Elshafie, Shaimaa Trivedi‐Kapoor, Rupal Ebell, Mark Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis |
title | Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis |
title_full | Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis |
title_fullStr | Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis |
title_full_unstemmed | Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis |
title_short | Safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis C patients: A systematic review and meta‐analysis |
title_sort | safety and efficacy of sofosbuvir‐based medication regimens with and without ribavirin in hepatitis c patients: a systematic review and meta‐analysis |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545628/ https://www.ncbi.nlm.nih.gov/pubmed/35678040 http://dx.doi.org/10.1111/jcpt.13698 |
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