Systematic review of the literature on comparative effectiveness of antiviral treatments for chronic XXXX .

@entity1 @entity97 @entity82 @entity16332 @entity24488 @entity1956 @entity96 @entity13211 @entity17705 @entity4020 @entity922
OBJECTIVES: To evaluate the comparative effectiveness of antiviral drugs in adults with chronic @entity1956 monoinfection for evidence-based decision-making. METHODS: A systematic review of @entity922 ( @entity922 ) published in English. Results after interferon and nucleos(t)ides analog therapies were synthesized with random-effects meta-analyses and number needed to treat (NNT). RESULTS: Despite sustained improvements in selected biomarkers, no one drug regimen improved all intermediate outcomes. In 16 underpowered @entity922 , drug treatments did not reduce mortality, @entity96 , or @entity82 . Sustained @entity97 DNA clearance was achieved in one @entity1 when two were treated with @entity24488 (NNT from 1 RCT=2 95%CI 1;2) or @entity4020 (NNT from 2 @entity922 =2 95%CI 2;4), 13 with @entity16332 (NNT from 1 RCT=13 95%CI 7;1000), and 11 with peginterferon alpha-2a vs. @entity16332 (NNT from 1 RCT=11 95%CI 7;25). Sustained @entity13211 seroconversion was achieved in one @entity1 when eight were treated with @entity4020 (NNT from 2 @entity922 =8 95%CI 5;33) or 10--with peginterferon alpha-2b vs. @entity4020 (NNT from 1 RCT=10 95%CI 5;1000). Greater benefits and safety after @entity17705 vs. @entity16332 or pegylated @entity4020 vs. @entity4020 require future investigation of clinical outcomes. Adverse events were common and more frequent after interferon. Treatment utilization for adverse effects is unknown. CONCLUSIONS: Individual clinical decisions should rely on comparative effectiveness and absolute rates of intermediate outcomes and adverse events. Future research should clarify the relationship of intermediate and clinical outcomes and cost-effectiveness of drugs for evidence-based policy and clinical decisions.
