Meta-analysis Shows Extended Therapy Improves Response of Patients With Chronic Hepatitis C Virus Genotype 1 Infection  Harald Farnik, Christian M. Lange, Christoph Sarrazin, Bernd Kronenberger, Stefan Zeuzem, Eva Herrmann  Clinical Gastroenterology and Hepatology  Volume 8, Issue 10, Pages 884-890 (October 2010) DOI: 10.1016/j.cgh.2010.06.019 Copyright © 2010 AGA Institute Terms and Conditions

Figure 1 Chance to achieve a sustained virologic response after extended treatment with pegIFN-alfa and ribavirin compared with 48 weeks of treatment. Risk differences to achieve an SVR after extended treatment compared with 48 weeks of treatment are shown. Positive risk differences indicate a higher chance to achieve an SVR after extended treatment compared with 48 weeks of treatment. Study populations were divided into subpopulations according to the time of being HCV RNA negative for the first time. Slow response is defined as HCV RNA decline of ≥2 log10 at week 12 of therapy and undetectable HCV RNA at week 24. The black squares indicate the risk difference of individual studies; the size of black squares corresponds inversely with the standard error which is determined mainly but not exclusively by sample size. Numbers above black squares indicate absolute numbers of patients with SVR after standard/extended treatment. The total numbers of patients treated with standard / extended treatment are indicated in brackets. Black lines through black bars represent CIs of individual studies. They show that improved SVR rates after extended treatment were only significant in a minority of individual studies. The risk difference of our meta-analysis in achieving an SVR was 14.7% in slow responders (95% CI, 4% to 25.5%; P = .0072), see dark gray diamond; and 12.6% in all patients (95% CI, 5.7% to 19.5%; P = .0004), see light gray diamond. Clinical Gastroenterology and Hepatology 2010 8, 884-890DOI: (10.1016/j.cgh.2010.06.019) Copyright © 2010 AGA Institute Terms and Conditions

Figure 2 Chance to achieve an EOT response after extended treatment with pegIFN-alfa and ribavirin compared with 48 weeks of treatment. Risk differences to achieve an EOT response after extended treatment compared with 48 weeks of treatment are shown, equivalent to Figure 1. Numbers above black squares indicate numbers of patients with EOT response after standard / extended treatment. The overall chance in achieving an EOT response was not improved in our meta-analysis. Risk difference for slow responders, −1.5% (95% CI, −12.5% to 9.6%; P = .80), see dark gray diamond; and for all patients, 1.5% (95% CI, −5.2% to 8.2%; P = .66), see light gray diamond. Clinical Gastroenterology and Hepatology 2010 8, 884-890DOI: (10.1016/j.cgh.2010.06.019) Copyright © 2010 AGA Institute Terms and Conditions

Figure 3 Risk of relapse after extended treatment with pegIFN-alfa and ribavirin compared with 48 weeks of treatment. Risk differences of relapse after extended treatment compared with 48 weeks of treatment are shown, equivalent to Figure 1. Numbers above black squares indicate numbers of patients with relapse after standard / extended treatment. Negative risk differences indicate a lower risk of relapse after extended treatment compared with 48 weeks of treatment. Risk difference for slow responders, −15.2% (95% CI, −22.2 to −8.3%; P < .0001), dark gray diamond; and for all patients −15.3% (95% CI, −20.3% to −10.4%; P < .0001), light gray diamond. Clinical Gastroenterology and Hepatology 2010 8, 884-890DOI: (10.1016/j.cgh.2010.06.019) Copyright © 2010 AGA Institute Terms and Conditions