Statin therapy improves response to interferon alfa and ribavirin in chronic hepatitis C: A systematic review and meta-analysis

• Published in: Antiviral research Vol. 98; no. 3; pp. 373 - 379
• Main Authors: Zhu, Qianqian, Li, Na, Han, Qunying, Zhang, Pingping, Yang, Cuiling, Zeng, Xiaoyan, Chen, Yanping, Lv, Yi, Liu, Xi, Liu, Zhengwen
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 01.06.2013; Elsevier
• Subjects: Adjuvants, Immunologic - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - administration & dosage; Antiviral Agents - therapeutic use; Biological and medical sciences; Chronic hepatitis C; Drug Therapy, Combination; Fatty Acids, Monounsaturated - administration & dosage; Genotype; Hepacivirus - genetics; Hepatitis C virus; Hepatitis C, Chronic - drug therapy; Human viral diseases; Humans; Indoles - administration & dosage; Infectious diseases; Interferon alfa; Interferon-alpha - administration & dosage; Interferon-alpha - therapeutic use; Medical sciences; Odds Ratio; Pharmacology. Drug treatments; Randomized Controlled Trials as Topic; Ribavirin; Ribavirin - administration & dosage; Ribavirin - therapeutic use; Statin; Treatment; Treatment Outcome; Viral diseases; Viral hepatitis; Viral Load; Chronic hepatitis C; Treatment; Statin; Interferon alfa; Ribavirin; Alpha interferon; Cytokine; Hepatic disease; Systematic review; Statin derivative; Review; Metaanalysis; Infection; Viral disease; Nucleoside analog; Digestive diseases; Antiviral; Antilipemic agent; Viral hepatitis C
• ISSN: 0166-3542; 1872-9096
• DOI: 10.1016/j.antiviral.2013.04.009

•Interferon alfa (IFN-α) and ribavirin for chronic hepatitis C achieve limited virological response.•The efficacy of adding statins to IFN-α and ribavirin was examined.•The addition of statins enhances sustained virological response.•The addition of statins does not increase adverse events and withdrawals.•Statins may be used as an adjuvant to IFN-α and ribavirin therapy for chronic hepatitis C. The treatment of interferon alfa (IFN-α) and ribavirin for chronic hepatitis C virus (HCV) infection achieves limited sustained virological response (SVR). We conducted a systematic review and meta-analysis to explore the efficacy of adding statins to IFN-α and ribavirin therapy for chronic hepatitis C. Studies with data pertinent to the effect of statins on chronic hepatitis C were reviewed, and randomized controlled trials (RCTs) evaluating the efficacy of the addition of statins to IFN-α and ribavirin were included in meta-analysis. The primary outcome measure was SVR. Secondary outcome measures were rapid virological response (RVR) and early virological response (EVR). The literature was systematically searched through October 2012. After screening of the 1724 non-duplicated entries, 54 potentially relevant studies were fully reviewed. Of those, 18 studies were relevant and 5 RCTs met the inclusion criteria for meta-analysis. In comparison with IFN-α and ribavirin therapy, the addition of statins significantly increased SVR (OR=2.02, 95% CI: 1.38–2.94), RVR (OR=3.51, 95% CI: 1.08–11.42) and EVR (OR=1.89, 95% CI: 1.20–2.98). The SVR increase remained significant for HCV genotype 1 (OR=2.11, 95% CI: 1.40–3.18). There were no significant increases in adverse events and withdrawals with the addition of statins. In conclusion, the addition of statins to IFN-α and ribavirin improves SVR, RVR, and EVR without additional adverse events and thus may be considered as adjuvant to IFN-α and ribavirin for chronic hepatitis C. Statins might also be used for HCV genotypes other than genotype 1, or in patients in whom the use of protease inhibitors is contraindicated or not indicated.