9901 r2 王人纬 - cgmhorgtw.pptVIP

NNT: 5 Conclusion The sustained response rate with pegylated interferon a-2b monotherapy in haemodialysis patients with chronic hepatitis C is low(22.2%, 0.0%), and also may be associated with a substantial number of adverse events. Level 2a Search strategy and data extraction National Library of Medicine MEDLINE and manual searches were combined The key-words ‘hepatitis C’, ‘interferon’,‘end-stage renal disease’, haemodialysis’ and‘dialysis’ were used. General reviews, references from published clinical trials, letters to pharmacological companies, and Current Contents were also used. All English and non-English articles were identified by a search from 1990 to July 2002. Data extraction was conducted independently by two investigators (F.F. and V.D.), and consensus was achieved for all data. Criteria for inclusion It had to be published as a peer-reviewed article, report the results of primary interferon monotherapy Use the sustained virological response (SVR) as a clinical end-point. Studies which included patients on maintenance haemodialysis or peritoneal dialysis were eligible. The mean rate of SVR: 37% The mean rate of drop-out: 17% Conclusions This meta-analysis shows that the tolerance to interferon is lower in dialysis than in non-uremic patients with chronic hepatitis C. However, more than one-third of haemodialysis patients with chronic hepatitis C have sustained virological response. Therapy should not be withheld from this group of patients, although their tolerance to side-effects may be less than that of non-uremic populations. Level 2b OBJECTIVES A prospective multicentre study was initiated in HCV-infected haemodialysis patients to assess the tolerance and effecacy of a-2b interferon Method Prospective study Patient number: 37 The dose of a-interferon was 3 million units three times weekly, to be reduced to 1.5 MU in case of side-effects. Tolerance was evaluated monthly; virological efficacy was evaluated by PCR. A liver biopsy was perfor