Peginterferon-alpha-2a (40 kD): A review of its use in chronic hepatitis B.

Abstract

Peginterferon-alpha-2a (40 kD) [Pegasys] comprises an inert, branched, 40 kD polyethylene glycol (PEG) moiety attached to interferon-alpha-2a. Subcutaneous peginterferon-alpha-2a (40 kD) is indicated for the treatment of adults with hepatitis B e antigen (HBeAg)-positive or -negative chronic hepatitis B who have compensated liver disease with evidence of viral replication and hepatic inflammation. Subcutaneous peginterferon-alpha-2a (40 kD) has antiviral and immunomodulatory properties and a convenient once-weekly administration schedule. Forty-eight weeks of therapy with peginterferon-alpha-2a (40 kD) with or without lamivudine was more effective than lamivudine alone in achieving a sustained response in patients with HBeAg-positive or -negative chronic hepatitis B. A long-term follow-up study in patients with HBeAg-positive disease who received peginterferon-alpha-2a (40 kD) monotherapy revealed an HBeAg seroconversion rate of 42%, 1 year after the end of treatment. A long-term follow-up study in patients with HBeAg-negative disease who received peginterferon-alpha-2a (40 kD) with or without lamivudine revealed hepatitis B surface antigen (HBsAg) clearance in 12% of patients and inactive chronic hepatitis B in 17% of patients, 5 years after the end of treatment. Various predictors of response may be useful in terms of identifying patients who may be candidates for shorter or longer peginterferon-alpha-2a (40 kD) treatment durations. For example, quantifying serum HBeAg (in HBeAg-positive disease) and HBsAg levels during therapy may be useful. Adverse events typical of the influenza-like symptoms seen with alpha-interferons occurred more frequently in patients with chronic hepatitis B receiving peginterferon-alpha-2a (40 kD) with or without lamivudine than in those receiving lamivudine alone. In conclusion, peginterferon-alpha-2a (40 kD) is a valuable option for the first-line treatment of HBeAg-negative or -positive chronic hepatitis B.

• Authors: Gillian M Keating
• Journal: Drugs (Drugs) Vol. 69 Issue 18 Pg. 2633-60 ( 2009) ISSN: 1179-1950 [Electronic] New Zealand
• PMID: 19943712 (Publication Type: Journal Article, Review)

Chemical References

• Antiviral Agents
• DNA, Viral
• Drug Carriers
• Hepatitis B Surface Antigens
• Hepatitis B e Antigens
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Lamivudine
• Polyethylene Glycols
• peginterferon alfa-2a

Topics

• Adult
• Age Factors
• Antiviral Agents (adverse effects, therapeutic use)
• DNA, Viral (blood)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Drug Carriers (administration & dosage)
• Drug Interactions
• Drug Therapy, Combination
• Hepatitis B Surface Antigens (therapeutic use)
• Hepatitis B e Antigens (genetics)
• Hepatitis B, Chronic (blood, drug therapy)
• Hepatitis C, Chronic (blood, drug therapy)
• Humans
• Interferon alpha-2
• Interferon-alpha (adverse effects, therapeutic use)
• Lamivudine (adverse effects, therapeutic use)
• Patient Selection
• Polyethylene Glycols (chemistry, therapeutic use)
• Prognosis
• Randomized Controlled Trials as Topic
• Recombinant Proteins
• Treatment Outcome