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Treatment for Hepatitis C Virus Infection in Adults: Comparative Effectiveness

Slide: 13 of 34

Triple Therapy Versus Dual Therapy Containing Boceprevir for Patients With Hepatitis C Virus Genotype 1 Infection

Two trials of patients with hepatitis C virus genotype 1 infection evaluated dual therapy lead-in with 4 weeks of pegylated interferon alfa-2b plus ribavirin followed by 44 weeks of triple therapy with boceprevir added to the dual-therapy regimen. Both trials were conducted in treatment-naïve patients with cirrhosis at baseline. The trials found that triple therapy was associated with a higher likelihood of achieving a sustained virologic response (SVR) than dual therapy for 48 weeks (pooled relative risk, 1.8; 95-percent confidence interval [95% CI], 1.6 to 2.1), with an absolute increase in the SVR rate of 31 percentage points (95% CI, 23 to 39). The strength of evidence for this finding was rated as moderate.

Two trials of triple therapy with boceprevir for 48 weeks (4 weeks of dual therapy lead-in with pegylated interferon alfa-2b plus ribavirin followed by 44 weeks of triple therapy with pegylated interferon, ribavirin, and boceprevir) found no difference in relative risk estimates for an SVR in men versus women, and no clear difference in relative risk estimates for black versus nonblack patients. Black race was associated with a lower absolute SVR rate than nonblack race.