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Effectiveness of generic direct-acting agents for the treatment of hepatitis C: systematic review and meta-analysis.


ABSTRACT: Objective:To compare the efficacy of generic direct-acting agents and brand-name medicines for treating hepatitis C virus (HCV) infection by conducting a systematic review and meta-analysis. Methods:We searched online databases for studies that reported sustained virological responses 12 weeks after the end of HCV treatment with generic direct-acting agents. We derived pooled proportions of treated patients with a sustained virological response from intention-to-treat and per-protocol analyses. In addition, we calculated the pooled relative risk (RR) of a sustained virological response brand-name versus generic direct-acting agents using a random-effects model (DerSimonian-Laird) from the data available. Between-study heterogeneity was assessed using the I2 statistic. Findings:We identified 19 studies involving a total of 57?433 individuals from eight territories or regions. The pooled overall proportions of patients with a sustained virological response were 98% (95% confidence interval, CI: 97-99; 18 studies; I2 ?=?94.1%) in per-protocol analyses and 96% (95% CI: 93-98; 8 studies; I2 ?=?68.1%) in intention-to-treat analyses. The likelihood of a sustained virological response with brand-name medicines was similar to that with generic direct-acting agents (RR: 1.00; 95% CI: 0.98-1.02; I2 ?=?0.0%). The likelihood of a sustained virological response was significantly higher in patients without than with cirrhosis (RR:1.03; 95% CI: 1.01-1.06; 7 studies) but was not significantly affected by either previous treatment (3 studies) or human immunodeficiency virus coinfection (3 studies). Conclusion:Generic direct-acting agents are highly effective for treating hepatitis C. Generic agents should be considered in resource-constrained settings for decreasing the burden of liver disease in HCV-infected patients.

SUBMITTER: Perazzo H 

PROVIDER: S-EPMC7047023 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Effectiveness of generic direct-acting agents for the treatment of hepatitis C: systematic review and meta-analysis.

Perazzo Hugo H   Castro Rodolfo R   Luz Paula M PM   Banholi Mariana M   Goldenzon Rafaela V RV   Cardoso Sandra W SW   Grinsztejn Beatriz B   Veloso Valdilea G VG  

Bulletin of the World Health Organization 20191108 3


<h4>Objective</h4>To compare the efficacy of generic direct-acting agents and brand-name medicines for treating hepatitis C virus (HCV) infection by conducting a systematic review and meta-analysis.<h4>Methods</h4>We searched online databases for studies that reported sustained virological responses 12 weeks after the end of HCV treatment with generic direct-acting agents. We derived pooled proportions of treated patients with a sustained virological response from intention-to-treat and per-prot  ...[more]

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