10). This report follows the PRISMA guidelines24 and the Cochrane collaboration guideline for reporting meta-analyses. Eight trials including naïve G1 patients comparing extended versus standard duration of peg-IFN plus ribavirin combination therapy were considered for this meta-analysis.7-10, 19, 21, 25-27 One trial was excluded because the longest extended treatment duration was 68 weeks.25 The DITTO-HCV study was also excluded because virologic outcome was not provided by the investigators.27 The six STA-9090 in vitro other trials published as full articles fulfilled the inclusion criteria. In two trials, patients received a

fixed 800-mg/day ribavirin regimen,7, 8 whereas in the four other trials, patients received a weight-based ribavirin regimen.

The study design was variable regarding Selleck GSK 3 inhibitor the randomization procedure at baseline, week 4, week 12, week 24, or week 36. Several studies reported the results of G1 and G4 patients together, so we restricted our report to G1 patients alone. The main characteristics of the selected trials are shown in Table 1. Of a total of 3,599 G1-naïve patients treated by peg-IFN plus ribavirin, 567 slow-responder patients were randomized to receive 48 versus 72 weeks of combination therapy. Slow virologic response was defined by detectable HCV RNA at week 12 despite a log drop in viral load of more than 2 from baseline and undetectable HCV RNA at week 24. Data from clinical trials comparing SVR after

48 or 72 weeks of combination therapy in G1 patients with slow virologic response are shown in Table 2. The 72-week extended duration of peg-IFN plus ribavirin therapy was associated with a significant increase in the rate of SVR, compared with the standard 48-week duration of therapy (39.4% versus 30.3%; risk ratio: 1.40; 95% CI: 1.11-1.77; P = 0.003). The increase in SVR rate associated with extended duration was 10.7% (weight-adjusted risk difference; 95% CI: +4.4% to +17.1%; P = 0.0009). This benefit was observed in trials that used a fixed 800-mg/day ribavirin regimen with an increase in SVR rate of 19.6% (95% CI: +4.8% to +34.3%; P = 0.009) and also in trials using a weight-based ribavirin regimen. The increase in SVR associated with MCE公司 extended duration was then 8.7% (95% CI: +1.7% to +15.8%; P = 0.014). This analysis is summarized in Fig. 1A. Rate of relapse was lower in the group treated for 72 weeks (16.0% versus 33.0%; risk ratio: 0.54; 95% CI: 0.37-0.77; P = 0.008). The weight-adjusted risk difference was –12.3% (−25.4% to 0%; P = 0.005). Rate of dropouts was not statistically different between the extended duration and the standard duration groups, despite a trend toward higher dropouts in the extended-duration group (16.6% versus 10.4%; risk ratio: 1.46; 95% CI: 0.98-2.19; P = 0.065). The weight-adjusted risk difference was +4.5% (95% CI: −0.6% to +9.6%; P = 0.082).