Peginterferon Alfa
Class: Interferons
VA Class: AM800
Brands: Pegasys, PegIntron, Sylatron
Warning
- Peginterferon Alfa-2a (Pegasys) and Peginterferon Alfa-2b (PegIntron)
May cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Monitor patients closely with periodic clinical and laboratory evaluations. Discontinue peginterferon alfa in patients with persistently severe or worsening signs or symptoms of these conditions. In many, but not all cases, these disorders resolve after the drug is discontinued.
Concomitant use of ribavirin may cause birth defects and/or death of the fetus. Use extreme care to avoid pregnancy in female patients and female partners of male patients. Ribavirin causes hemolytic anemia; this may result in worsening of cardiac disease.
- Peginterferon Alfa-2b (Sylatron)
Increased risk of serious depression, with suicidal ideation and completed suicides, and other serious neuropsychiatric disorders. Permanently discontinue peginterferon alfa-2b in patients with persistently severe or worsening signs or symptoms of depression, psychosis, or encephalopathy. These disorders may not resolve after stopping the drug.
Introduction
Antiviral and antineoplastic agent; contains interferon alfa (recombinant DNA origin) covalently bound to monomethoxy polyethylene glycol (PEG). Available as peginterferon alfa-2a (Pegasys) and peginterferon alfa-2b (PegIntron) for treatment of certain viral infections; peginterferon alfa-2b also available in higher concentrations (Sylatron) for use as an antineoplastic agent.
Uses for Peginterferon Alfa
Chronic HBV Infection
Peginterferon alfa-2a (Pegasys): Treatment of chronic HBV infection in adults with hepatitis B e antigen (HBeAg)-positive or -negative infection, compensated liver disease, and evidence of viral replication and liver inflammation.
Goal of antiviral therapy is sustained suppression of HBV replication and remission of liver disease; long-term goal is prevention of cirrhosis, hepatic failure, and hepatocellular carcinoma.
Currently available therapies (e.g., interferon alfa, peginterferon alfa, adefovir, entecavir, lamivudine, telbivudine, tenofovir) do not eradicate HBV and may have only limited long-term efficacy. When making decisions regarding treatment, consider patient’s age, severity of liver disease, likelihood of response, safety and efficacy of the drug, potential for selection of resistant HBV strains, potential for adverse reactions, costs, patient’s pregnancy potential, and patient and provider preferences.
American Association for the Study of Liver Diseases (AASLD) states that drugs of choice for initial treatment of chronic HBV infection in patients with compensated liver disease are peginterferon alfa, entecavir, or tenofovir, unless contraindicated or ineffective. Efficacy of peginterferon alfa and nonconjugated interferon alfa are considered similar, but peginterferon alfa dosage schedule more convenient and generally preferred.
Although safety and efficacy not established for treatment of chronic HBV infection in patients coinfected with HIV, some experts recommend peginterferon alfa as an alternative for treatment of HBV in some adults coinfected with HIV.
Treatment of chronic HBV infection is.
