The Relative Efficacy of Boceprevir and Telaprevir in the Treatment of HCV Genotype 1.
Schmitz S, O'Leary A, Walsh C, Bergin C, Norris S.
Source
Department of Statistics, Trinity College Dublin, Ireland.
Abstract
Background.
The licensing of direct-acting anti-virals heralds a new era in the treatment of HCV genotype 1. There are no head-to-head trials examining their comparative efficacy and there are none currently registered. We undertook a mixed treatment comparison to examine the relative efficacy among current treatments for HCV.
Methods.
A systematic literature review identified relevant studies. Meta-analyses were planned in treatment-naïve and treatment-experienced patients. Study arms which evaluated telaprevir or boceprevir for unlicensed durations or without both pegylated-interferon and ribavirin at standard doses were excluded. A Bayesian mixed treatment comparison model was fitted for each patient population. Potential influence of confounders was analysed using meta-regression.
Results.
499 studies were identified, 10 studies met inclusion criteria. In the subgroup of prior treatment "relapsers" telaprevir had greater relative efficacy than boceprevir (Odds Ratio 2.61(1.24, 5.52)).
There were no statistically significant differences detected in relative efficacy for other patient categories. Treatment-naïve patients: boceprevir versus standard-of-care (n= 1417) Odds Ratio 3.06(2.43, 3.87); telaprevir versus standard-of-care (n=1309) Odds Ratio 3.24(2.56, 4.10); telaprevir versus boceprevir Odds Ratio 1.06(0.75, 1.47). Total treatment-experienced population: boceprevir versus standard-of-care (n=604) Odds Ratio 6.53(4.20, 10.32); telaprevir versus standard-of-care (n=891) Odds Ratio 8.32(5.69, 12.36); telaprevir versus boceprevir Odds Ratio 1.27(0.71, 2.30).
Conclusions.
Telaprevir had greater relative efficacy than boceprevir in patients who had previously relapsed. There was insufficient evidence to detect a difference in treatment outcomes between the two agents in the overall population. It was not possible to determine relative efficacy for subgroups such as cirrhotics due to small numbers.
Sept 29 2012
Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients : an indirect comparison using Bayesian network meta-analysis.
The licensing of direct-acting anti-virals heralds a new era in the treatment of HCV genotype 1. There are no head-to-head trials examining their comparative efficacy and there are none currently registered. We undertook a mixed treatment comparison to examine the relative efficacy among current treatments for HCV.
Methods.
A systematic literature review identified relevant studies. Meta-analyses were planned in treatment-naïve and treatment-experienced patients. Study arms which evaluated telaprevir or boceprevir for unlicensed durations or without both pegylated-interferon and ribavirin at standard doses were excluded. A Bayesian mixed treatment comparison model was fitted for each patient population. Potential influence of confounders was analysed using meta-regression.
Results.
499 studies were identified, 10 studies met inclusion criteria. In the subgroup of prior treatment "relapsers" telaprevir had greater relative efficacy than boceprevir (Odds Ratio 2.61(1.24, 5.52)).
There were no statistically significant differences detected in relative efficacy for other patient categories. Treatment-naïve patients: boceprevir versus standard-of-care (n= 1417) Odds Ratio 3.06(2.43, 3.87); telaprevir versus standard-of-care (n=1309) Odds Ratio 3.24(2.56, 4.10); telaprevir versus boceprevir Odds Ratio 1.06(0.75, 1.47). Total treatment-experienced population: boceprevir versus standard-of-care (n=604) Odds Ratio 6.53(4.20, 10.32); telaprevir versus standard-of-care (n=891) Odds Ratio 8.32(5.69, 12.36); telaprevir versus boceprevir Odds Ratio 1.27(0.71, 2.30).
Conclusions.
Telaprevir had greater relative efficacy than boceprevir in patients who had previously relapsed. There was insufficient evidence to detect a difference in treatment outcomes between the two agents in the overall population. It was not possible to determine relative efficacy for subgroups such as cirrhotics due to small numbers.
Sept 29 2012
Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients : an indirect comparison using Bayesian network meta-analysis.
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