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Treatment of Anemia and Neutropenia in Patients with Chronic Hepatitis C Infection Treated with Peginterferon-Ribavirin Based Regimens With or Without Protease Inhibitors: A Review of the Clinical Evidence

Published on: March 8, 2012
Project Number: RC0327-002
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical efficacy and safety of erythropoietin versus ribavirin dose reduction for the treatment of anemia in patients with chronic hepatitis C infection who are treated with peginterferon and ribavirin (PR) with or without protease inhibitors?
  2. What is the comparative clinical efficacy and safety of filgrastim versus interferon dose reduction for the treatment of neutropenia in patients with chronic hepatitis C infection who are treated with PR with or without protease inhibitors?

Key Message

At present, there is no clear evidence that would suggest an advantage of one intervention (pharmacological intervention versus dose reduction) over another as a strategy for managing neutropenia in patients with chronic hepatitis C infection treated with PR. The evidence supporting the use of EPO versus ribavirin dose reduction in patients treated with PR who experience anemia is limited to small, underpowered studies. There is currently no evidence comparing pharmacological intervention with dose reduction in patients treated with protease inhibitor-PR regimens who experience anemia or neutropenia.

Tags

hepatitis, anemia, hepatitis c, interferons, neutropenia, protease inhibitors, ribavirin, hepatitis c virus, interferon-alpha, interferon alfa, interferon, alpha, hepatitis c, chronic, chronic hepatitis c