The Cochrane Review Conclusion for Hepatitis C DAA Therapies is Wrong
Am J Gastroenterol 2018; 113:2–4; doi: 10.1038/ajg.2017.420; published online 14 November 2017
Snip from abstract: It is therefore surprising and disappointing that the recent Cochrane database review of DAAs for chronic hepatitis C concluded that DAA administration has little or no clinical relevance to patients with hepatitis C, stating that it was questionable if SVR has any clinical relevance ( 28 ). This manuscript correctly concluded that (i) the currently available DAAs offer high rates of SVR and cure HCV infection in nearly all patients treated with these medications and (ii) that there was no benefit of such treatments within the study duration that the DAAs were evaluated on the primary end points defined by the Cochrane group, which were hepatitis C-related morbidity, serious adverse events, and quality of life. However, none of these elements were considered primary end points of the DAA trials analyzed by this Cochrane analysis. This latter point represents a gross departure from the typical Cochrane methodology, which limits itself to the end points of the clinical trials examined and does not extrapolate these end points…