Efficacy of interferon-based therapy in the treatment of thalassaemic patients with chronic hepatitis C - A meta-analysis

Objective: To identify the interferon-alpha (IFN alpha) treatment protocol most suitable for patients with thalassaemia major who have chronic hepatit is C. Design and setting: This was a meta-analysis of studies in the internationa l literature between 1990 and 1999. Methods: Studies were identified from a search of Medline and Embase, and a nalysed by the Mantel-Haenszel-Peto statistical method. Results: We identified 6 nonrandomised trials, 2 of which were controlled, that treated a total of 201 patients, Most studies used the lowest dose lev el (3 MIU/m(2)), all used a thrice-weekly regimen, and most used IFN alpha- 2b, although the use of natural IFN alpha did not induce production of anti -interferon antibodies. The best sustained response and remission rates ten ded to be achieved with higher doses and longer cycles of IFN alpha. Conclusions: The best interferon-based therapy to treat polytransfused thal assaemic patients with chronic hepatitis C is represented by the use of nat ural IFN alpha or IFN alpha-2b, initially at high dosages (5 to 10 MIU/m(2) 3 times weekly) for 6 months, followed by lower dosages (3 MIU/m(2) 3 time s weekly) for a further 6 to 9 months.