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ABSTRACT 19
Will lambda interferon replace
pegylated interferon?
DT Dieterich
Mount Sinai School of Medicine, New York, NY, USA
Since the first approval of interferon for the
treatment of non-A, non-B hepatitis, researchers
have been looking for ways to improve the efficacy
and particularly the toxicity of interferon. Pegylating
interferon increased the half life to as long as 160
hours from only a few hours and increased the
efficacy substantially. However, while some side
effects were slightly better, the majority were still
extremely difficult to tolerate for most patients.
Lambda interferon or IL29 which binds to receptors
found almost exclusively on the hepatocyte, is a vast
improvement over interferon alfa. Data presented
at EASL 2011 showed more rapid viral decay for
all genotypes, 1-4, indicating increased potency
against these viruses. More importantly, the adverse
events reported were remarkably different than
peginterferon alfa. There was virtually no neutropenia
or thrombocytopenia with lambda compared to peg.
There was about one gram of hemoglobin drop, due
to ribavirin, but as illustrated in an AASLD abstract
(1343) peg lambda patients were able to mount a
healthy erythropoiesis response to ribavirin hemolysis
in the presence of peg lambda. Another important use
for peg lambda is in cirrhotics, who have notoriously
decreased bone marrow activity. The results of the
EMERGE trial were shown with much less hematologic
toxicity and similar antiviral activity in Childs A
compensated cirrhotics. (AASLD 1344).
It seems in all likelihood; at the two lower doses that
lambda interferon is a superior interferon to alfa
interferon, at least through phase II trials. The burning
question, however on everyone’s mind, is whether we
will need interferon at all in the treatment of HCV.
Those results will be discussed.
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发表于 2011-12-15 14:16
