peginterferon alfa-2a
{{Short description|Pharmaceutical drug}}
{{Use dmy dates|date=March 2024}}
{{Infobox drug
| Verifiedfields = changed
| verifiedrevid = 458269040
| image =
| width =
| alt =
| caption =
| pronounce =
| tradename = Pegasys, others
| Drugs.com = {{drugs.com|ppa|peginterferon-alfa-2a}}
| MedlinePlus = a605029
| DailyMedID = Peginterferon_alfa-2a
| pregnancy_AU = B3
| pregnancy_AU_comment =
| pregnancy_category =
| routes_of_administration = Subcutaneous injection
| class =
| ATC_prefix = L03
| ATC_suffix = AB11
| ATC_supplemental =
{{ATC|L03|AB61}} (in combinations)
| legal_AU = S4
| legal_AU_comment =
| legal_BR =
| legal_BR_comment =
| legal_CA =
| legal_CA_comment =
| legal_DE =
| legal_DE_comment =
| legal_NZ =
| legal_NZ_comment =
| legal_UK = POM
| legal_UK_comment =
| legal_US = Rx-only
| legal_US_comment =
| legal_EU = Rx-only
| legal_UN =
| legal_UN_comment =
| legal_status = Rx-only
| bioavailability =
| protein_bound =
| metabolism =
| metabolites =
| onset =
| elimination_half-life =
| duration_of_action =
| excretion =
| index2_label = alfa-2b
| CAS_number_Ref = {{cascite|correct|CAS}}
| CAS_number = 198153-51-4
| CAS_number2_Ref = {{cascite|correct|CAS}}
| CAS_number2 = 215647-85-1
| CAS_supplemental =
| PubChem =
| IUPHAR_ligand =
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB00008
| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
| ChemSpiderID = none
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = Q46947FE7K
| UNII2_Ref = {{fdacite|correct|FDA}}
| UNII2 = G8RGG88B68
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D02748
| ChEBI_Ref =
| ChEBI =
| ChEMBL_Ref = {{ebicite|changed|EBI}}
| ChEMBL = 1201560
| NIAID_ChemDB =
| PDB_ligand =
| synonyms =
| IUPAC_name =
| C=860 | H=1353 | N=227 | O=255 | S=9
}}
Pegylated interferon alfa-2a, sold under the brand name Pegasys among others, is medication used to treat hepatitis C and hepatitis B. For hepatitis C it is typically used together with ribavirin and cure rates are between 24 and 92%.{{cite web|title=Pegasys 135 mcg and 180 mcg solution for injection in pre-filled pen - Summary of Product Characteristics (SPC) - (eMC)|url=https://www.medicines.org.uk/emc/medicine/32432|website=medicines.org.uk|access-date=12 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170113131243/https://www.medicines.org.uk/emc/medicine/32432|archive-date=13 January 2017}} For hepatitis B it may be used alone.{{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|page=639|edition=69}} It is given by injection under the skin.{{cite web|title=Peginterferon Alfa-2a (Professional Patient Advice) |url=https://www.drugs.com/ppa/peginterferon-alfa-2a.html|website=drugs.com|access-date=12 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170116181400/https://www.drugs.com/ppa/peginterferon-alfa-2a.html|archive-date=16 January 2017}}
Side effects are common. They may include headache, feeling tired, depression, trouble sleeping, hair loss, nausea, pain at the site of injection, and fever. Severe side effects may include psychosis, autoimmune disorders, blood clots, or infections. Use with ribavirin is not recommended during pregnancy. Pegylated interferon alfa-2a is in the alpha interferon family of medications. It is pegylated to protect the molecule from breakdown.{{cite web|title=Peginterferon alfa-2a (Pegasys) - Treatment - Hepatitis C Online|url=http://www.hepatitisc.uw.edu/page/treatment/drugs/peginterferon-alfa-drug|website=hepatitisc.uw.edu|access-date=12 January 2017|url-status=live|archive-url=https://web.archive.org/web/20161223133654/http://www.hepatitisc.uw.edu/page/treatment/drugs/peginterferon-alfa-drug|archive-date=23 December 2016}}
Pegylated interferon alfa-2a was approved for medical use in the United States in 2002. It is on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}
Medical uses
This drug is approved around the world for the treatment of chronic hepatitis C (including people with HIV co-infection, cirrhosis, 'normal' levels of ALT) and has recently been approved (in the EU, U.S., China and many other countries) for the treatment of chronic hepatitis B. It is also used in the treatment of certain T-cell lymphomas, particularly mycosis fungoides.{{citation needed|date=January 2023}}
Peginterferon alfa-2a is a long acting interferon. Interferons are proteins released in the body in response to viral infections. Interferons are important for fighting viruses in the body, for regulating reproduction of cells, and for regulating the immune system.{{Cite web|url=https://www.drugs.com/mtm/interferon-alfa-2a.html|title=Interferon alfa-2a Uses, Side Effects & Warnings|website=Drugs.com|language=en|access-date=10 January 2020}}
= Host genetic factors=
For genotype 1 hepatitis C treated with pegylated interferon alfa-2a or pegylated interferon alfa-2b combined with ribavirin, it has been shown that genetic polymorphisms near the human IL28B gene, encoding interferon lambda 3, are associated with significant differences in response to the treatment. This finding, originally reported in Nature,{{cite journal|title=Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance |vauthors=Ge D, Fellay J, Thompson AJ, etal |journal=Nature |year=2009 |volume=461|pages=399–401 |pmid=19684573 |doi=10.1038/nature08309|issue=7262|bibcode=2009Natur.461..399G |s2cid=1707096 }} showed genotype 1 hepatitis C patients carrying certain genetic variant alleles near the IL28B gene are more likely to achieve sustained virological response after the treatment than others. Another report in Nature demonstrated the same genetic variants are also associated with the natural clearance of the genotype 1 hepatitis C virus.{{cite journal|title=Genetic variation in IL28B and spontaneous clearance of hepatitis C virus |vauthors=Thomas DL, Thio CL, Martin MP, etal |journal=Nature |year=2009 |pmid=19759533 |doi=10.1038/nature08463|volume=461|issue=7265|pages=798–801|pmc=3172006|bibcode=2009Natur.461..798T }}
Manufacturing
It is pegylated with a branched 40{{nbsp}}kg/mol PEG chain.{{cite journal | vauthors = Rajender Reddy K, Modi MW, Pedder S | title = Use of peginterferon alfa-2a (40 KD) (Pegasys) for the treatment of hepatitis C | journal = Advanced Drug Delivery Reviews | volume = 54 | issue = 4 | pages = 571–86 | date = June 2002 | pmid = 12052715 | doi = 10.1016/s0169-409x(02)00028-5 }}
Society and culture
= Availability =
Peginterferon alfa-2a is manufactured under the brand name Pegasys. In 2021, Roche Pharmaceuticals sold the worldwide rights of Pegasys (excluding China and Japan) to zr pharma& GmbH (pharma&).{{cite web | title=Pegasys (peginterferon alfa-2a) | publisher=Genentech | url=https://www.gene.com/patients/medicines/pegasys | access-date=8 January 2023 | archive-date=8 January 2023 | archive-url=https://web.archive.org/web/20230108213950/https://www.gene.com/patients/medicines/pegasys | url-status=dead }}{{cite web|title=Verzichtserklärung der Zulassung - Mittelfristig läuft Pegasys aus|url=https://assets.cwp.roche.com/f/94122/x/2b0bc67a9f/mittelfristig-luft-pegasys-aus-original-1176.pdf|publisher=Roche |language=de |access-date=4 December 2021|archive-date=4 December 2021|archive-url=https://web.archive.org/web/20211204170553/https://assets.cwp.roche.com/f/94122/x/2b0bc67a9f/mittelfristig-luft-pegasys-aus-original-1176.pdf|url-status=dead}}{{cite web|title=Pegasys (Peginterferon alfa-2a) langfristig weiterhin erhältlich|url=https://assets.cwp.roche.com/f/94122/x/8f2de3daec/kurzmeldung-pegasys-bleibt-verfugbar.pdf|publisher=Roche|language=de|access-date=4 December 2021|archive-date=4 December 2021|archive-url=https://web.archive.org/web/20211204170551/https://assets.cwp.roche.com/f/94122/x/8f2de3daec/kurzmeldung-pegasys-bleibt-verfugbar.pdf|url-status=dead}}{{cite web|title=pharma& portfolio|url=https://www.pharmaand.com/portfolio-rx|publisher=zr pharma& GmbH |access-date=4 December 2021}}{{cite web|title=Half-Year Report 2021, p.20|url=https://www.roche.com/dam/jcr:7260c9fc-2310-4305-bc10-ca3cea0de87d/en/hy21e.pdf|publisher=Roche|access-date=4 December 2021|archive-date=24 November 2021|archive-url=https://web.archive.org/web/20211124190028/https://www.roche.com/dam/jcr:7260c9fc-2310-4305-bc10-ca3cea0de87d/en/hy21e.pdf|url-status=dead}} In May 2022, Roche Australia transferred the sales and marketing of Pegasys to Echo Therapeutics Pty Ltd.{{cite web | title=Pegasys | publisher=Roche Australia | url=https://www.roche-australia.com/en_au/products/pharmaceuticals/pegasys.html | access-date=8 January 2023}}
Research
A Cochrane Review sought to determine whether interferon alfa-2a could be used as a treatment for individuals with neovascular age-related macular degeneration. They found no evidence of improved visual acuity with potential harm.{{cite journal |vauthors= Reddy U, Krzystolik M |title= Antiangiogenic therapy with interferon alfa for neovascular age-related macular degeneration |journal=Cochrane Database of Systematic Reviews |volume=1 |pages= CD005138 |date=2006 |issue= 1 |pmid= 16437522|doi= 10.1002/14651858.CD005138.pub2}}
References
{{Reflist}}
External links
{{Commons category|Interferon-alpha 2a}}
- {{MeshName|Pegasys}}
{{Interferons}}
{{Immunostimulants}}
{{DNA antivirals}}
{{RNA antivirals}}
{{Cytokine receptor modulators}}
{{Portal bar | Medicine | Viruses }}
{{Authority control}}
Category:World Health Organization essential medicines
Category:Drugs developed by Hoffmann-La Roche