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Concept
Peginterferon alfa-2b
Summary
Pegylated interferon alfa-2b is a drug used to treat melanoma, as an adjuvant therapy to surgery. Also used to treat hepatitis C (typically, in combination with ribavarin), it is no longer recommended due to poor efficacy and adverse side-effects. Subcutaneous injection is the preferred delivery method.
Belonging to the alpha interferon family of medications, the molecule is PEGylated to prevent breakdown. Approval for medical use in the United States was granted in 2001. It is on the World Health Organization's List of Essential Medicines as a therapy for chronic hepatitis C.
Till around 2010, PEGylated interferon alfa-2b in combination with ribavirin, was part of the standard regimen used in management of hepatitis C. Ribivarin helped in increasing the Sustained Virologic Response (SVR) even more. Developed by Schering-Plough, the drug was approved by Food and Drug Administration (FDA) of the United States in 2001, and has been on the World Health Organization's List of Essential Medicines as a therapy for chronic hepatitis C since 2013.
A 2013 meta-analysis over Clinical Infectious Diseases noted the combination-treatment to be safe as well as effective for children and adolescents; other meta-analyses had noted the same for adult population. A 2012 meta-analysis had found PEGylated interferon alfa-2a to be the more effective variant for treatment-naive patients.
With the advent of Direct-Acting-Antivirals (DAAs — ), interferon-based treatment regimens gradually fell out of fashion due to relatively poor efficacy and high frequency of adverse side-effects. No longer recommended, the use of PEGylated interferon alfa-2b has essentially ceased in all countries, where DAA therapeutics are available.
For high-risk melanoma, it is used as an adjuvant therapy to surgery in some countries. It was first approved for the purpose by FDA on March 29, 2011, based on a single phase III trial.
The usage remains controversial — frequency of severe side-effects is high, overall survival benefits substantially vary across different trials, and there is no consensus on the dosage regimen.
Official source
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