Tuesday, June 27, 2017

MedPage Today - Hep C Experts Condemn Cochrane Review Dissing Direct Antivirals

Today the European Association for the Study of the Liver EASL published a response to the Cochrane Systematic Review that suggested there was no evidence new treatments for hepatitis C improve outcomes in patients infected with the virus. Other rebuttals can be viewed over at Gastroenterology & Endoscopy News, and in the Lancet, as well as a statement by the American Association for the Study of Liver Diseases AASLD and Infectious Diseases Society of America IDSA. In Australia a joint Position Statement was released by Australian Health Organisations   urging medical professionals and patients not to be influenced by the report. In addition Hepatitis C Trust responded with concern over media coverage, citing an article published by The GuardianIn the week following the Cochrane review, an excerpt:
In an extraordinary show of unity, hepatitis C researchers, clinicians, and advocates have denounced the Cochrane analysis and its implications, pointing to clear-cut evidence that current DAAs not only cure hepatitis C, but also reduce the risk of liver transplant, cancer, and other complications later in life..
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June 27, 2017
Response to the Cochrane Systematic Review on DAA-Based Treatment of Chronic Hepatitis C
The European Association for the Study of the Liver, one of the world leading associations of liver specialists, feels compelled to express its serious concerns after the recent publication of a Cochrane Group systematic review entitled “Direct acting antivirals for chronic hepatitis C” by Jakobsen et al. After reviewing 138 clinical trials, including 25,232 participants, the authors conclude that: “Overall, direct acting antivirals (DAAs) on the market or under development do not seem to have any effects on risk of serious adverse events. […] we could neither confirm nor reject that DAAs had any clinical effects. DAAs seemed to reduce the risk of no sustained virological response. The clinical relevance of the effects of DAAs on no sustained virological response is questionable, as it is a non-validated surrogate outcome. All trials and outcome results were at high risk of bias, so our results presumably overestimate benefit and underestimate harm. The quality of the evidence was very low.”
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Reactions from Hepatitis C Community on a Recent Cochrane Review of DAAs
Cochrane Review Group's fallacious conclusions are missing real issue of access to effective and highly curative therapy for chronic HCV infection. Irresponsible reporting by news media of the results risks even more harm than the original review.

A special thank you to Henry E. Chang for sending us to each rebuttal and all ongoing media coverage.

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