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Evidence summaries

Ribavirin Monotherapy for Chronic Hepatitis C

Ribavirin alone appears to have no significant beneficial effect on virological response and liver morbidity in chronic hepatitis C as compared to placebo or no intervention, but may improve biochemical and histological response transiently. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 14 studies with a total of 657 subjects. Compared with placebo/no intervention, ribavirin had no significant effect on sustained (RD 0%, 95% CI -2% to 3%, 5 studies, n=353) or end of treatment virological response (RD 0% 95% CI -3% to 3%, 10 studies, n=513). Ribavirin had no significant effect on liver-related morbidity plus mortality (RD 0%, 95% CI -2% to 3%, 11 studies, n= 521). Ribavirin significantly improved end of treatment biochemical and histological response but not sustained biochemical response. Further, ribavirin significantly increased the risk of anaemia. Ribavirin was significantly inferior to interferon regarding virological and biochemical response (5 studies).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

    References

    • Brok J, Gluud LL, Gluud C. Ribavirin monotherapy for chronic hepatitis C. Cochrane Database Syst Rev 2009;(4):CD005527[PubMed]

Primary/Secondary Keywords