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Spotlight on Peginterferon-α-2a (40KD) in Chronic Hepatitis C

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Abstract

Peginterferon-α-2a (40KD) is a new ‘pegylated’ subcutaneous formulation of interferon-α-2a that has been developed to improve on the pharmacokinetic profile and therapeutic efficacy of interferon-α-2a. Peginterferon-α-2a (40KD) is produced by the covalent attachment of recombinant interferon-α-2a to a branched mobile 40KD polyethylene glycol moiety, which shields the interferon-α-2a molecule from enzymatic degradation, reduces systemic clearance and enables once-weekly administration.

Peginterferon-α-2a (40KD) was significantly more effective than interferon-α-2a in interferon-α therapy-naive adults with chronic hepatitis C in three nonblind, randomised, multicentre trials. Virological responses (intention-to-treat results) were achieved in 44 to 69% of patients with or without cirrhosis after 48 weeks of treatment with peginterferon-α-2a (40KD) 180 μg/week; sustained virological responses 24 weeks after the end of treatment occurred in 30 to 39% of patients. Virological responses at the end of treatment and at long-term follow-up were significantly higher than those achieved with interferon-α-2a. Peginterferon-α-2a (40KD) was significantly more effective than interferon-α in patients with or without cirrhosis infected with HCV genotype 1.

Sustained biochemical responses achieved with peginterferon-α-2a (40KD) 180 μg/week ranged from 34 to 45% and were significantly higher than with interferon-α-2a. Recipients of peginterferon-α-2a (40KD) also experienced histological improvements; 24 weeks after discontinuation of treatment with peginterferon-α-2a (40KD) 180 μg/week, 54% to 63% of patients had a ≥2-point improvement in histological activity index score. Peginterferon-α-2a (40KD) produced histological responses in patients (with or without cirrhosis) with or without a sustained virological response.

Peginterferon-α-2a (40KD) produced better results than interferon-α-2a alone or interferon-α-2b plus oral ribavirin on various measures of quality of life in patients with chronic hepatitis C.

The tolerability profile of peginterferon-α-2a (40KD) is broadly similar to that of interferon-α-2a in patients with chronic hepatitis C with or without cirrhosis. Headache, fatigue and myalgia are among the most common adverse events.

In conclusion, peginterferon-α-2a (40KD) administered once weekly produces significantly higher sustained responses, without compromising tolerability, than interferon-α-2a administered thrice weekly in noncirrhotic or cirrhotic patients with chronic hepatitis C, including those infected with HCV genotype 1 — a group in whom interferon-α treatment has usually been unsuccessful. Peginterferon-α-2a (40KD) is a valuable new treatment option and appears poised to play an important role in the first-line treatment of patients with chronic hepatitis C, including difficult-to-treat patients such as those with compensated cirrhosis and/or those infected with HCV genotype 1.

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Acknowledgements

The full text of this article appeared in Drugs 2001; 61 (14): 2263–2288 and was reviewed by: A. Alberti, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy; W.G.E. Cooksley, Department of Medicine, Royal Brisbane Hospital, Brisbane, Australia; G. Dusheiko, Department of Medicine, Royal Free Hospital and School of Medicine, London, England; G.R. Foster, Liver Unit and Department of Histopathology, Department of Medicine, Imperial College of Medicine at St Mary’s, London, England; E.B. Keeffe, Stanford University Medical Center, Palo Alto, California, USA; J. Main, General Medicine and Infectious Diseases, Imperial College of Medicine at St Mary’s Hospital, London, England; J. Rasenack, University Clinic of Freiburg, Freiburg, Germany; S. Zeuzem, Medizinische Klinik 2, Klinikum der Johann Wolfgang Goethe Universitat, Frankfurt, Germany.

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  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand

    Caroline M. Perry & Blair Jarvis

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  1. Caroline M. Perry
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  2. Blair Jarvis
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Correspondence to Caroline M. Perry.

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The full text of this article was published in Drugs 2001; 61 (5): 2263–2288

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Perry, C.M., Jarvis, B. Spotlight on Peginterferon-α-2a (40KD) in Chronic Hepatitis C. BioDrugs 16, 213–217 (2002). https://doi.org/10.2165/00063030-200216030-00006

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