Peginterferon alpha

Castelnau C, Le Gal F, Ripault MP, Gordien E, Martinot-Peignoux M, Boyer N, Pham BN, Maylin S, Bedossa P, Deny P, MarcelUn P, Gault E (2006) Efficacy of peginterferon alpha-2b in chrome hepatitis delta relevance of quantitative RT-PCR for follow-up. Hepatology 44 728-735... 

Peginterferon alpha, either peginterferon alfa-2a or peginterferon alfa-2b, with ribavirin is recommended for treatment of those aged 18 years and over who have not previously received an interferon, or who have received such treatment but where response was inadequate. Choice of treatment depends on viral load and genotype. Treatment of patients with coincident HIV infection requires specialist advice. 

Pockros, P.J., Carithers, R., Desmond, R, Dhumeaux, D., Fried, M.W., Marcellin, R, Shiffman, M.L., Minuk, G., Reddy, K.R., Reindollar, R.W., Lin, A., Brunda, M.J. Efficacy and safety of two-dose regimens of peginterferon alpha-2a compared with interferon controlled trial. Amer. J. Gastroenterol. 2004 99 1298-1305... 

Bruno, R., Sacchi, P., Ciappina, V, Zochetti, C., Patruno, S., Maiocchi, L., Filice, G. Viral dynamics and pharmacokinetics of peginterferon alpha-2a and peginterferon alpha-2b in naive patients with chronic hepatitis C a randomized, controlled study. Antiviral Ther. 2004 9 491-497... 

Peginterferon alpha-2b Polyethylene glycol (PEG)-lntron Schering Corp. 

Peginterferon alpha-2a is a covalent conjugate of recombinant alpha-2a interferon (approximate MW is 20,000 Da) with a single branched d/s-monomethoxy PEG chain (approximate MW is 40,000 Da). Peginterferon alpha-2a has an approximate MW of 60,000 Da. 

Peginterferon alpha-2b is a covalent conjugate of recombinant alpha interferon with monomethoxy PEG. The MW of the PEG portion of the molecule is 12,000 Da. The average MW of the PEG-intron molecule is approximately 31,000 Da. 

Patel, K., McHutchison, ). 2001. Peginterferon alpha-2b a new approach to improving response in hepatitis C patients. Expert Opin Pharmacother 2, 1307-1315. 

Such Dfaz A, Barrueco N, Esteban Alba C, Escobar Rodriguez I. Trombosis venosa retiniana asociada a peginterferdn alfa 2b mas ribavirina en un paciente con hepatitis C crdnica. [Retinal vein thrombosis associated with peginterferon alpha 2b plus ribavirin in a chronic hepatitis C patient.] Farm Hosp 2011 35 93-4. 

Wang BY, Chang HH, Chen IM, Shih CC, Yang AH. Peginterferon alpha-2b and acute allograft failure in a heart transplant recipient. Ann Thorac Surg 2010 89(5) 1645-7. 

Shin MK, Kim TH, Ju K, Ha CY, Min HJ, Jung WT, Lee OJ. A case of sudden-onset hearing loss in a patient treated with peginterferon alpha-2b and ribavirin for chronic hepatitis C. Korean J Hepatol 2009 15(3) 370. ... 

Fernandez A, Vfizquez S, Rodrrguez-Gonz lez L. Tongue hyperpigmentation resulting from peginterferon alpha-2a and ribavirin treatment in a Caucasian patient with chronic hepatitis C. J Eur Acad Dermatol Venereol 2008 22(11) 1389-91. 

Suzuki F, Suzuki Y, Sezaki H, Akuta N, Seko Y, Kawamura Y, et al. Exploratory study on telaprevir given every 8 h at 500 mg or 750 mg with peginterferon-alpha-2b and ribavirin in hepatitis C patients. Hepatol Res 2013 43(7) 691-701. 

Chronic HCV- In combination with peginterferon alfa-2a for the treatment of adults with chronic HCV infection who have compensated liver disease and have not been previously treated with interferon alpha. Patients in whom efficacy was demonstrated included patients with compensated liver disease and histological evidence of cirrhosis (Child-Pugh class A). 

Alpha interferons, including peginterferon alfa-2a, may cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. 

Bone marrow toxicity Peginterferon alfa-2a suppresses bone marrow function and may result in severe cytopenias. Ribavirin may potentiate the neutropenia and lymphopenia induced by alpha interferons including peginterferon alfa-2a. Alpha interferons may be associated with aplastic anemia very rarely. 

Ophthaimoiogic disorders Decrease or loss of vision, retinopathy (including macular edema, retinal artery or vein thrombosis), retinal hemorrhages and cotton wool spots, optic neuritis, and papilledema are induced or aggravated by treatment with peginterferon alfa-2a or other alpha interferons. All patients should receive an eye examination at baseline. 

Puimonary disorders Dyspnea, pulmonary infiltrates, pneumonia, bronchiolitis obliterans, interstitial pneumonitis, and sarcoidosis, some resulting in respiratory failure and/or patient deaths, may be induced or aggravated by peginterferon alfa-2a or alpha interferon therapy. 

Alpha interferons, including peginterferon alfa-2b, cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Closely monitor patients with periodic clinical and laboratory evaluations. Withdraw from therapy patients with persistently severe or worsening signs or symptoms of... 

Neuropsychiatric events Life-threatening or fatal neuropsychiatric events, including suicide, suicidal and homicidal ideation, depression, relapse of drug addiction/overdose, and aggressive behavior have occurred in patients with and without a previous psychiatric disorder during peginterferon alfa-2b treatment and follow-up. Psychoses, hallucinations, bipolar disorders, and mania have been observed in patients treated with alpha interferons. 

Elderly Treatment with alpha interferons, including peginterferon alfa-2b, is associated with CNS, cardiac, and systemic (flu-like) adverse effects. Because these adverse reactions may be more severe in the elderly, exercise caution in the use of interferon alfa-2b in this population. 

Organ transplants The safety and efficacy of peginterferon alfa-2b alone or in combination with ribavirin capsules for the treatment of hepatitis C in patients who have received liver or other organ transplants have not been studied. Preliminary data indicate that interferon alpha therapy may be associated with an increased rate of kidney graft rejection. Liver graft rejection also has been reported, but a causal... 

A type of interferon produced by white blood cells, alpha interferon, has been engineered and produced to keep the progression of hepatitis C virus, a serious liver infection, under control. The first alpha interferons were slightly modified forms of natural interferon alpha produced in E. coli. More recent versions, peginterferon and... 

Treatment options for viral hepatitis include lamivu-dine, simple interferon alpha, polyethylene glycol-linked interferon (Peginterferon alfa-2a), and ade-fovir and ribavirin. Selected regimes have markedly improved response rates, but relapse is still common. 

Peginterferon alfa-2a treatment results in more sustained responses than simple interferon alpha, although relapse is not uncommon. Such treatment should generally be avoided in those receiving immunosuppressants and those with decompensated liver disease. Lamivudine, a reverse transscriptase inhibitor is often used in initial treatment and in decompensated liver disease. 

National Institute for Health and Clinical Excellence. Hepatitis B (chronic) - adefovir dipivoxil and peginter-feron alpha-2a. Technology appraisal TA096. [2006], Available from URL www.nice.org.uk National Institute for Health and Clinical Excellence. Hepatitis C peginterferon and ribavirin. Technology appraisal TA106. [2006]. Available from URL WWW. nice. org. uk... 

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