A small trial failed to demonstrate that interferon alfa-2b prevented cirrhosis in HBeAg-positive patients. Another small RCT found no significant difference in histologically confirmed cirrhosis after interferon alfa-2b alone or with simultaneous prednisone. No data were available from RCTs for other antiviral drugs or longer followup.
Hepatic decompensation was not prevented by lamivudine compared to placebo or entecavir compared to lamivudine in three underpowered trials.
Overall, 49% of patients discontinued their medication before the end of the four-year study, with 36% due to failure to comply and 13% due to side effects. Peginterferon alfa-2b was generally well tolerated. Among patients who discontinued due to interferon side effects (17.1%, 49/286), the most common reason (45%, 22/49 patients) was general intolerance to interferon (e.g., due to flu-like symptoms, malaise, and other common interferon side effects).
http://www.nature.com/eye/journal/v17/n4/full/6700391a.html
"INF-alpha therapy has been known to cause a variety of ocular lesions.1,2 Typical lesions include cottonwool spots and retinal haemorrhages at the posterior fundus, particularly around the optic disc, secondary to retinal ischaemia, which usually appear within 3 months of the onset of therapy.
I'm the opposite of Frijole. I did 2b first and failed treatment, 2a the second time. Although successful it was not due to the 2a. But, I found that the side effects were much less than 2b.
Ribavirin dosage normally is weight based, with a normal maximum of 12,000 (6 pills) a day. I weigh 144 lbs, so I started out at 1,000 mg a day, 3 in the morning and 2 at night. The doctor may do a lot of adjustments during the treatment also.
Here is some info:
http://www.drugs.com/dosage/ribavirin.
Pegasys is a brand name for Peginterferon alfa-2a or Pegylated interferon alfa-2a which is an antiviral drug made by La Roche. It is given by injection. It is used in combination with another medication called Ribavirin (a pill), and a third medication, either Victrellis or Incivek, which are both pills, to treat Hepatitis C.
Let us know if you have further questions.
NOTE: Consider response prognostic factors, HCV genotype, viral load, and disease progression evidence such as hepatic inflammation and fibrosis when deciding to treat a pediatric patient. Weigh treatment benefits against potential safety risks identified in clinical trials (see Contraindications/Precautions).
Pegylation of interferon alfa-2b produces a product (PegIntron) whose clearance is lower than that of nonpegylated interferon alfa-2b. When compared to INTRON A, PegIntron (1 mcg/kg) has approximately a 7-fold lower mean apparent clearance and a 5-fold greater mean half-life, permitting a reduced dosing frequency. At effective therapeutic doses, PegIntron has approximately 10-fold greater Cmax and 50-fold greater AUC than interferon alfa-2b.
These include albinterferon, controlled-release recombinant interferon alfa, maxy-alfa interferon, oral interferon, and implantable mini-pump technology to deliver continuous interferon infusion.
Albinterferon* was developed by genetically fusing human albumin to interferon alfa. The concept is that this recombinant agent will have a longer sustainable half-life and thus allow a reduction in the frequency of interferon administration.
These results are similar to those seen with the 48-week treatment regimen of VICTRELIS added to peginterferon alfa-2b and ribavirin in HCV RESPOND-2, a pivotal Phase III study. Taken together, these studies showed that VICTRELIS combined with either peginterferon alfa-2a or alfa-2b and ribavirin achieved significantly higher SVR rates in chronic HCV genotype 1 patients who failed prior therapy compared to peginterferon and ribavirin alone.
In a separate study, Shiffman and colleagues[40] found that genotype 1 HCV–infected patients treated with peginterferon alfa-2b plus high-dose ribavirin 15.2 mg/kg/day (1000-1600 mg/day) supported by adjuvant epoetin alfa were more likely to achieve SVR than those treated with a standard ribavirin dose (13.3 mg/kg/day [800-1400 mg/day]) and epoetin alfa support (49% vs 29%, respectively; P < .05).
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