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Evidence summaries

Glucocorticosteroids for Viral Hepatitis C

Glucocorticoids for up to 6 months are probably not effective for chronic viral hepatitis C. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 8 studies with a total of 384 subjects. Glucocorticosteroids as a short pre-treatment followed by interferon or as long-term parallel treatment combined with interferon versus interferon monotherapy had no significant effect on mortality (no deaths occurred; 342 patients), virological response at six months follow-up (RR for not having are response 0.85; 95% CI 0.52 to 1.38; 38 patients), or biochemical response at six months follow-up (RR 0.95; 95% CI 0.84 to 1.06; 307 patients). There was no significant difference in serious adverse events between combination therapy versus interferon monotherapy (RR 4.76; 95% CI 0.24 to 93.19; 342 patients). Glucocorticosteroids versus interferon had no significant effect on mortality (RR 2.33; 95% CI 0.27 to 17.80; 13 patients) or virological response at follow-up (RR 1.17; 95% CI 0.86 to 1.58; 13 patients). No trials on glucocorticosteroids for acute hepatitis C were found.

Comment: The quality of evidence is downgraded by limitations in study quality (e.g. unclear allocation concealment and inadequate follow up) and by imprecise results (few patients and wide confidence intervals).

References

  • Brok J, Mellerup MT, Krogsgaard K, Gluud C. Glucocorticosteroids for viral hepatitis C. Cochrane Database Syst Rev 2004;(2):CD002904. [PubMed]

Primary/Secondary Keywords