Patients Treated With Pegylated Interferon Have More Complete Responses

July 2, 2003 -- A new form of an old hepatitis drug appears to be a more effective hepatitis B treatment. Twice as many patients taking a longer-acting version of the drug interferon -- called pegylated interferon -- had effective results as patients on standard interferon.

This first trial comparing the two hepatitis B treatments is published in the July issue of the Journal of Viral Hepatitis.

Last year, the FDA approved pegylated interferon for patients with hepatitis C virus infection. Standard interferon has been around for many years. But the pegylated form of interferon has been altered to allow the treatment to stay in the bloodstream longer. As a result, hepatitis C patients get pegylated interferon once a week -- compared with three injections a week for standard interferon. Hepatitis B patients often get daily injections.

The hepatitis B virus is transmitted through body fluids and is 100 times more contagious than HIV, but the infection goes away on its own in most patients. But when the infection does take hold, treatment is needed to prevent life-threatening liver failure.

Approved hepatitis B treatments for those who become chronically infected include standard interferon and the drugs lamivudine and adefovir. Lamivudine and adefovir are more easily tolerated than interferon, but most patients do not achieve long-term responses.

In this study, 194 patients with chronic hepatitis B were randomly chosen to receive either standard interferon, three times a week, or three different doses of the pegylated interferon PEGASYS once a week for six months. All the patients were then followed for an additional six months.

PEGASYS is manufactured by Roche Pharmaceuticals, a WebMD sponsor.

At the end of the follow-up, 24% of the patients on pegylated interferon had measurable responses to the hepatitis B treatment, compared with 12% on standard interferon.

Of those on the middle dose of PEGASYS, 33% had sustained suppression of the hepatitis B virus six months after the end of hepatitis B treatment, compared with 25% of patients on standard interferon.

"The viral reduction achieved with PEGASYS is substantially more pronounced than what's achieved with conventional interferon," lead researcher Graham Cooksley, MD, said in a news release.

But Howard J. Worman, MD, who has written several books on hepatitis treatment, says he's not convinced that pegylated interferon represents a significant advanced over standard interferon for the treatment of chronic hepatitis B.

The Columbia University professor tells WebMD that new drugs are being tested for hepatitis B treatment, but they are not very different from the already approved drugs lamivudine and adefovir.

"With hepatitis C there are bigger drugs on the horizon with different mechanisms of action than those now on the market," he says. "But I don't see that with hepatitis B."

SOURCES: Journal of Viral Hepatitis, July 2003. Graham Cooksley, MD, FRACP, Royal Brisbane Hospital, Herston, Australia. Howard J. Worman, MD, associate professor of medicine and anatomy and cell biology, College of Physicians and Surgeons, Columbia University, New York.

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