The Comparative Efficacy and Safety of Peginterferon Alpha-2a vs. 2b for the Treatment of Chronic HCV Infection: A Meta-Analysis

Two types of peginterferon, alpha-2a (peg-ifn-α 2a) and 2b (peg-ifn-α 2b), are approved for the treatment of hepatitis c infection. several high-quality studies have compared the efficacy of these two types of interferon, but it seems that any of these trials had inadequate statistical power on their own to find even a tiny difference between these two medicines. we pooled the available data in the literature to find any small difference between these two medicines.methods: in a systematic review of the literature, randomized controlled trials comparing the use of peg-α 2a vs. 2b were assessed. the dersimonian and laird method was employed to run meta-analysis. the end points were virological responses.results: in 7 randomized controlled trials, 3518 patients were randomized to receive peg-ifn-α 2a + ribavirin (n=1762) or peg-ifn-α 2b + ribavirin (n=1756). early virological response (evr), early treatment response (etr), and sustained virological response (svr) were greater for patients treated with peg-ifn-α 2a. odds ratios (ors) were 1.38 (95% confidence interval [ci] 1.11-1.71), 1.67 (95% ci 1.24-2.24), and 1.38 (95% ci 1.02-1.88) respectively. in the subset of naïve patients with genotype 1/4 and 2, ors of svr were 1.38 (95% ci 1.02-1.88) and 4.06 (95% ci 1.67-9.86) respectively. peg-ifn-α 2a had significantly higher rate of neutropenia or=1.50 (95% ci 1.25-1.79) but pooled or for withdrawal rates was not significant [or=0.78 (95% ci 0.47-1.29)].conclusions: peg-ifn-α 2a with similar safety is more effective than peg-ifn-α 2b. a longer duration of maximum serum concentration compared with peg-ifn-α 2b (168 vs. 48-72 h.) yields a greater svr and higher neutropenia in peg-ifn-α 2a recipients.