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Treatment for Hepatitis C Virus Infection in Adults: Comparative Effectiveness

Slide: 21 of 34

Triple Therapy With Boceprevir Versus Dual Therapy in Patients With HCV Genotype 1 Infection: Adverse Effects

Triple therapy with boceprevir for 48 weeks (pegylated interferon alfa-2b plus ribavirin for 4 weeks plus boceprevir for another 44 weeks) was associated with increased risk of neutropenia (2 trials; pooled relative risk [RR], 1.8; 95-percent confidence interval [95% CI], 1.5 to 2.3), dysgeusia (2 trials; pooled RR, 2.5; 95% CI, 2.0 to 3.2), anemia (2 trials; pooled RR, 2.0; 95% CI, 1.4 to 2.8), and thrombocytopenia (2 trials; pooled RR, 3.3; 95% CI, 1.3 to 8.6) than with dual therapy (pegylated interferon alfa-2b plus ribavirin). With triple therapy, the incidence of anemia was about 50 percent, the incidence of neutropenia was about 25 percent, the incidence of severe anemia was 4–5 percent, and the incidence of severe neutropenia was 8–15 percent. There was no difference in the overall risk of withdrawal due to adverse events between the two treatment groups. The strength of evidence for this finding was rated moderate.