Peginterferon Alfa-2b

Peginterferon Alfa-2b Uses, Dosage, Side Effects, Food Interaction and all others data.

Peginterferon Alfa-2b is a form of recombinant interferon used as part of combination therapy to treat chronic Hepatitis C, an infectious liver disease caused by infection with Hepatitis C Virus (HCV). HCV is a single-stranded RNA virus that is categorized into nine distinct genotypes, with genotype 1 being the most common in the United States, and affecting 72% of all chronic HCV patients . Treatment options for chronic Hepatitis C have advanced significantly since 2011, with the development of Direct Acting Antivirals (DAAs) resulting in less use of Peginterferon Alfa-2b. Peginterferon Alfa-2b is derived from the alfa-2b moeity of recombinant human interferon and acts by binding to human type 1 interferon receptors. Activation and dimerization of this receptor induces the body's innate antiviral response by activating the janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. Use of Peginterferon Alfa-2b is associated with a wide range of severe adverse effects including the aggravation and development of endocrine and autoimmune disorders, retinopathies, cardiovascular and neuropsychiatric complications, and increased risk of hepatic decompensation in patients with cirrhosis. The use of Peginterferon Alfa-2b has largely declined since newer interferon-free antiviral therapies have been developed.

In a joint recommendation published in 2016, the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) no longer recommend Peginterferon Alfa-2b for the treatment of Hepatitis C . Peginterferon Alfa-2b was used alongside Ribavirin(https://go.drugbank.com/drugs/DB00811) with the intent to cure, or achieve a sustained virologic response (SVR), after 48 weeks of therapy. SVR and eradication of HCV infection is associated with significant long-term health benefits including reduced liver-related damage, improved quality of life, reduced incidence of Hepatocellular Carcinoma, and reduced all-cause mortality .

Peginterferon Alfa-2b is available as a variable dose injectable product (tradename Pegintron) used for the treatment of chronic Hepatitis C. Approved in 2001 by the FDA, Pegintron is indicated for the treatment of HCV with Ribavirin or other antiviral drugs . When combined together, Peginterferon Alfa-2b and Ribavirin have been shown to achieve a SVR between 41% for genotype 1 and 75% for genotypes 2-6 after 48 weeks of treatment.

Trade Name Peginterferon Alfa-2b
Generic Peginterferon alfa-2b
Peginterferon alfa-2b Other Names Peginterferon alfa-2b
Weight 296mcg, 444mcg, 888mcg, 120mcg, 50mcg,
Type Subcutaneous Kit, Subcutaneous Powder For Injection, Subcutaneous
Weight 31000.0 Da
Groups Approved
Therapeutic Class
Manufacturer
Available Country United States
Last Updated: September 19, 2023 at 7:00 am
Peginterferon Alfa-2b
Peginterferon Alfa-2b

Uses

Peginterferon Alfa-2b is a purified form of human interferon used to stimulate the innate antiviral response in the treatment of hepatitis B and C, genital warts, and some cancers.

Peginterferon Alfa-2b is indicated for the treatment of HCV in combination with Ribavirin and a NS3/4A protease inhibitor for genotype 1 or without a NS3/4A protease inhibitor for genotypes 2-6 . May be used as a monotherapy in patients with contraindications to or significant intolerance to other anti-viral therapies.

Peginterferon Alfa-2b is also used to associated treatment for these conditions: Chronic Hepatitis C Virus (HCV) Infection, Melanomas

How Peginterferon Alfa-2b works

Peginterferon Alfa-2b is derived from recombinant human interferon's alfa-2b moeity . It binds to and activates human type 1 interferon receptors causing them to dimerize. This activates the JAK/STAT pathway. Activation of the JAK/STAT pathway increases expression of multiple genes in multiple tissues involved in the innate antiviral response. Peginterferon Alfa-2b may also acitvate the nuclear factor κB pathway.

Toxicity

Peginterferon Alfa-2b may manifest neuropsychiatric complications include suicide, suicidal ideation, homicidal ideation, depression, relapse of drug addiction, and drug overdose . Hypertension, supraventricular arrhythmias, chest pain, and myocardial infarction have been observed in patients using Peginterferon Alfa-2b. Peginterferon Alfa-2b may produce myelosuppression as well as the development or aggravation of autoimmune disorders including myositis, hepatitis, thrombotic thrombocytopenic purpura, idiopathic thrombocytopenic purpura, psoriasis, rheumatoid arthritis, interstitial nephritis, thyroiditis, and systemic lupus erythematosus. Peginterferon Alfa-2b causes or aggravates hypothyroidism and hyperthyroidism. Hyperglycemia, hypoglycemia, and diabetes mellitus have been observed to develop in patients treated with Peginterferon Alfa-2b. Peginterferon Alfa-2b may decrease or produce loss of vision, retinopathy including macular edema, retinal artery or vein thrombosis, retinal hemorrhages and cotton wool spots, optic neuritis, papilledema and serous retinal detachment. Peginterferon mayy be related to increased ischemic and hemorrhagic cerebrovascular events. Patients with cirrhosis on Peginterferon Alfa-2b are at risk of hepatic decompensation. Dyspnea, pulmonary infiltrates, pneumonia, bronchiolitis obliterans, interstitial pneumonitis, pulmonary hypertension and sarcoidosis may be induced or aggravated by Peginterferon Alfa-2b. Serious and severe infections (bacterial, viral, or fungal) have been reported during treatment with Peginterferon Alfa-2b. Ulcerative and hemorrhagic/ischemic colitis have been observed within 12 weeks of starting Peginterferon Alfa-2b treatment. Pancreatitis and peripheral nephropathy have also been reported. Peginterferon Alfa-2b is associated with growth inhibition in pediatric patients. Use of Peginterferon Alfa-2b while pregant may result in delopmental abnormalities or death of the fetus.

Food Interaction

  • Limit caffeine intake. Peginterferon Alfa-2b can increase the serum levels of caffeine by inhibiting its metabolism through the CYP1A2 pathway.

Elimination Route

Peginterferon Alfa-2b reaches peak plasma concentration 15-44 hours after subcutaneous administration . The mean absorption half-life is 4.6 hours. After multiple doses the bioavailability of Peginterferon Alfa-2b increases with trough concentrations at week 48 3-fold higher than those at week 4.

Half Life

The mean half-life of elimination of Peginterferon Alfa-2b is 40 hours in a range of 22-60 hours .

Clearance

The estimated apparent clearance of Peginterferon Alfa-2b is 22 milliters per hour per kilogram .

Elimination Route

Renal elimination accounts for 30% of Peginterferon Alfa-2b elimination .

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