EASL Response to the Cochrane Systematic Review on DAA-Based Treatment of Chronic Hepatitis C

The members of the Executive Board of the World Hepatitis Alliance (WHA) have written an open letter to the Cochrane Collaboration in which they raise doubts about the recent Cochrane review of direct-acting antivirals (DAAs) for the treatment of hepatitis C. The WHA points to the unsound methodology leading to unreliable conclusions. For instance, the review evaluated clinical trials designed to assess sustained virological response (SVR), against morbidity and mortality, variables for which they were not designed. Also, the review included drugs that were withdrawn because of safety concerns or poor efficacy. It worries the WHA that governments will believe that something emanating from the Cochrane Collaboration must be true based on its reputation. If governments now believe that DAAs have no beneficial effect, the WHO global strategy to eliminate hepatitis B and C as a public health concern by 2030 will be undermined. The WHA therefore invites the Cochrane Collaboration to address the methodological issues raised by the WHA. Download the article.