PEGylation benefits

A recent randomized multicenter trial compared the efficacy of pegylated lFN-a2a monotherapy, adefovir monotherapy, and the pegylated lFN-a2a/adefovir combination administered for 48 weeks to patients with chronic hepatitis D. Adefovir did not inhibit HDV replication, and the combination had no additional benefit compared with pegylated IFN-a monotherapy in terms of the HDV RNA level (Yurdaydin et al. 2006). 

The use, benefits, and adverse effects of aldesleukin in HIV-infected patients have been extensively reviewed (8). Aldesleukin significantly increased the CD4+ cell count without an increase in viral load. However, many questions remain unanswered. In particular, it is still not known whether immunological improvements translate into clinical benefit. Regardless of how aldesleukin is administered—intravenously, subcutaneously, or as polyethylene glycol-modified (pegylated) aldesleukin— adverse effects are generally not treatment-limiting. As the duration of adverse effects was shorter with the subcutaneous route, these patients may be treated as outpatients (9). 

Porter CA, Rifkin RM (2007) Clinical benefits and economic analysis of pegylated liposomal doxorubicin/vinciistine/dexamethasone versus doxorubicin/vincristine/dexamethasone in patients with newly diagnosed multiple myeloma. Clin Lymphoma Myeloma S4 S150-S155... 

Ten to thirty percent of patients progress to cirrhosis after 30 years. Most individuals with chronic HCV in the United States are between the ages of 30 and 49 years and have yet to manifest sequelae of the disease. As a result, the impact of HCV on future health care costs is anticipated to be high. Unfortunately, clinical decisions to treat individual patients are confounded by the inconsistent progression and a lack of ability to predict clinical deterioration. Therapy with pegylated interferons and ribavirin can be very expensive and associated with serious adverse events. Consequently, assessing the cost, benefits, and cost-effectiveness of the various therapies is vital. 

The attachment of PEG to bioactive macromolecules is called PEGylation and provides various benefits [312]. These include better water solubility, enhanced resistance to proteolysis, decrease of immimogenicity, antigenicity, toxicity of drugs and slower rate of kidney clearance [313]. PEG has been approved for use in drugs, food and cosmetics [314]. The monodispersity of todays available PEGs eliminates former risks that were related to impurities foimd during chemical synthesis of PEG. 

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