Evidence map›Paper›PMID 24349487›Full record

SynthesisPloS one2013

Is sustained virological response a marker of treatment efficacy in patients with chronic hepatitis C viral infection with no response or relapse to previous antiviral intervention?

Kurinchi S Gurusamy, Edward Wilson, Ronald L Koretz, Victoria B Allen, Brian R Davidson, Andrew K Burroughs, Christian Gluud

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 6 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 6 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Aminoadamantanes versus other antiviral drugs for chronic hepatitis C.The Cochrane database of systematic reviews · 2014
    Pooled it
  2. Aminoadamantanes for chronic hepatitis C.The Cochrane database of systematic reviews · 2014
    Pooled it
  3. Nitazoxanide for chronic hepatitis C.The Cochrane database of systematic reviews · 2014
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Article
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Kurinchi S GurusamyDepartment of Surgery, University College London, London, United Kingdom.
Edward WilsonHealth Economics Group, University of East Anglia, Norwich, United Kingdom ; Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, United Kingdom.
Ronald L KoretzCochrane Hepato Biliary Group, Granada Hills, California, United States of America.
Victoria B AllenDepartment of Surgery, University College London, London, United Kingdom.
Brian R DavidsonDepartment of Surgery, University College London, London, United Kingdom.
Andrew K BurroughsSheila Sherlock Liver Centre and Institute of Liver and Digestive Health, Royal Free Hospital, and UCL, London, United Kingdom.
Christian GluudCochrane Hepato-Biliary Group, The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet,Copenhagen University Hospital, Copenhagen, Denmark.
University College London · GBCochrane · DKThe Royal Free Hospital · GBUniversity of Cambridge · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRandomised clinical trials (RCTs) of antiviral interventions in patients with chronic hepatitis C virus (HCV) infection use sustained virological response (SVR) as the main outcome. There is sparse information on long-term mortality from RCTs.

methodsWe created a decision tree model based on a Cochrane systematic review on interferon retreatment for patients who did not respond to initial therapy or who relapsed following SVR. Extrapolating data to 20 years, we modelled the outcome from three scenarios: (1) observed medium-term (5 year) annual mortality rates continue to the long term (20 years); (2) long-term annual mortality in retreatment responders falls to that of the general population while retreatment non-responders continue at the medium-term mortality; (3) long-term annual mortality in retreatment non-responders is the same as control group non-responders (i.e., the increased treatment-related medium mortality "wears off").

resultsThe mean differences in life expectancy over 20 years with interferon versus control in the first, second, and third scenarios were -0.34 years (95% confidence interval (CI) -0.71 to 0.03), -0.23 years (95% CI -0.69 to 0.24), and -0.01 (95% CI -0.3 to 0.27), respectively. The life expectancy was always lower in the interferon group than in the control group in scenario 1. In scenario 3, the interferon group had a longer life expectancy than the control group only when more than 7% in the interferon group achieved SVR.

conclusionsSVR may be a good prognostic marker but does not seem to be a valid surrogate marker for assessing HCV treatment efficacy of interferon retreatment. The SVR threshold at which retreatment increases life expectancy may be different for different drugs depending upon the adverse event profile and treatment efficacy. This has to be determined for each drug by RCTs and appropriate modelling before SVR can be accepted as a surrogate marker.

Indexed as

HepacivirusHepatitis CLife ExpectancyModels, BiologicalAntiviral AgentsDisease-Free SurvivalFemaleHumansMaleSurvival RateAntiviral Agents

Identifiers

PMID24349487
PMCPMC3861485
OpenAlexW2160509407

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.