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peginterferon alfa 2a (Pegasys)

Polyethylene-glycol modified interferon alfa 2a. Tradename: Pegasys Indications: 1) treatment of chronic hepatitis B [2] 2) treatment of hepatitis C Dosage: - weekly SC injections (48 weeks) [2] - 1.5 ug/kg/week [4] - 180 ug/week Pharmacokinetics: -> longer 1/2 life than unmodified IFN-alfa 2a may result in better antiviral activity Monitor: - liver function tests (serum ALT, serum bilirubin) baseline, 4 weeks, then periodically - in clinical studies, LFTs were monitored at weeks 1, 2, 4, 6, & 8, then every 4-6 weeks or more frequently if abnormal [5] Adverse effects: - influenza-like syndrome (fatigue, headache, fever) [7] - depression, insomnia, irritability [7] - relatively common - treatment with escitalopram diminishes depression associated with interferon alfa 2A [6] - neutropenia, thrombocytopenia, anemia - autoimmune thyroiditis [7] - see interferon alfa 2A Laboratory: - IFNL3 variation rs12979860 predicts response to PEG-interferon-alpha [8]

Related

hepatitis C virus

General

peginterferon interferon [IFN]-alfa 2a (Roferon-A)

References

  1. Journal Watch 21(2):14, 2001 Zeuzem et al N Engl J Med 343:1666, 2000 Heathcote et al N Engl J Med 343:1673, 2000
  2. Journal Watch 24(21):162-63, 2004 Marcellin P, Lau GK, Bonino F, Farci P, Hadziyannis S, Jin R, Lu ZM, Piratvisuth T, Germanidis G, Yurdaydin C, Diago M, Gurel S, Lai MY, Button P, Pluck N; Peginterferon Alfa-2a HBeAg-Negative Chronic Hepatitis B Study Group. Peginterferon alfa-2a alone, lamivudine alone, and the two in combination in patients with HBeAg-negative chronic hepatitis B. N Engl J Med. 2004 Sep 16;351(12):1206-17. PMID: 15371578
  3. Department of Veterans Affairs, VA National Formulary
  4. Ghany MG et al AASLD PRACTICE GUIDELINES Diagnosis, Management, and Treatment of Hepatitis C: An Update American Association for the Study Liver Diseases (AASLD) 2009, Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hep.22759 http://www.aasld.org/practiceguidelines/Documents/AASLD_PG--diagnosis_of_HEP_C_2009.pdf
  5. Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Liver Function Test Scheduling Detail-Document#: 260704 (subscription needed) http://www.prescribersletter.com
  6. Schaefer M et al Escitalopram for the Prevention of Peginterferon- alpha-2a-Associated Depression in Hepatitis C Virus- Infected Patients Without Previous Psychiatric Disease: A Randomized Trial. Annals of Internal Medicine, July 17, 2012 PMID: 22801672 http://annals.org/article.aspx?articleid=1216554
  7. Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
  8. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline information for boceprevir, peginterferon alfa-2a, peginterferon alfa-2b, ribavirin, telaprevir and IFNL3. https://www.pharmgkb.org/guideline/PA166110235

Components

polyethylene glycol [PEG] (Go-Lytely, CoLyte, Miralax, Glycolax)