Rustgi Vinod K
Georgetown University Medical Center, 8316 Arlington Blvd., Fairfax, VA 22031, USA.
Curr Med Res Opin. 2009 Apr;25(4):991-1002. doi: 10.1185/03007990902779186.
New treatment options for chronic hepatitis C (CHC) that offer improved efficacy, tolerability, and convenience compared with weekly interferon alfa (IFNalpha)-based regimens are needed. Longer-acting IFNalpha formulations with reduced dosing requirements and improved tolerability have been a focus of drug development efforts. The objective of this report is to review the characteristics, pharmacokinetics, pharmacodynamics, and clinical and virologic outcomes reported in studies of albinterferon alfa-2b (alb-IFN), a novel fusion protein of human albumin and human IFNalpha-2b.
This review was based on all published data regarding alb-IFN to date. An unlimited PubMed database search was conducted using the keywords 'albuferon,' 'albinterferon,' and 'albumin AND interferon.'
Albinterferon alfa-2b has been developed for the treatment of CHC. This agent exhibits a prolonged half-life and duration of antiviral activity that indicate potential suitability for dosing intervals of 2-4 weeks. Phase 2 trials in prior IFN nonresponders and IFN-naïve patients with genotype 1 or 2/3 CHC have shown antiviral activity and acceptable safety/tolerability of alb-IFN 900-1500 microg every 2 weeks and 1200-1500 microg every 4 weeks. Based on the phase 2 data, alb-IFN 900 microg and 1200 microg every 2 weeks were selected for two ongoing phase 3 trials in IFN-naïve patients with genotype 1 and 2/3 CHC.
Albinterferon alfa-2b exhibits high antiviral activity, and appears to offer safety/tolerability comparable to the current standard of care, and health-related quality-of-life benefits in patients with CHC. Its ability to maintain drug concentrations above the 90% effective concentration over prolonged dosing intervals suggests that it may be an ideal partner for combination therapy with direct antiviral agents in CHC. The results of the phase 3 trials are eagerly anticipated as they should greatly clarify the future role of alb-IFN in the treatment of CHC.
需要有新的慢性丙型肝炎(CHC)治疗方案,与基于每周使用干扰素α(IFNα)的治疗方案相比,这些新方案应具有更高的疗效、更好的耐受性和更高的便利性。具有更低给药频率要求和更好耐受性的长效IFNα制剂一直是药物研发工作的重点。本报告的目的是回顾关于聚乙二醇化干扰素α-2b(alb-IFN)(一种人白蛋白与人IFNα-2b的新型融合蛋白)的研究中所报道的特性、药代动力学、药效学以及临床和病毒学结果。
本综述基于迄今为止所有已发表的关于alb-IFN的数据。使用关键词“聚乙二醇化干扰素”“聚乙二醇化干扰素α”以及“白蛋白与干扰素”对PubMed数据库进行了不限定范围的检索。
聚乙二醇化干扰素α-2b已被开发用于治疗CHC。该药物具有延长的半衰期和抗病毒活性持续时间,这表明它可能适合每2至四周给药一次。在既往对IFN无反应者以及初治的1型或2/3型CHC患者中进行的2期试验表明,每2周给予900 - 1500微克以及每4周给予1200 - 1500微克的alb-IFN具有抗病毒活性且安全性/耐受性良好。基于2期试验数据,每2周给予900微克和1200微克的alb-IFN被选用于两项正在进行的针对初治的1型和2/3型CHC患者的3期试验。
聚乙二醇化干扰素α-2b具有高抗病毒活性,似乎具有与当前标准治疗相当的安全性/耐受性,并能使CHC患者的健康相关生活质量受益。其在延长的给药间隔期间将药物浓度维持在90%有效浓度以上的能力表明,它可能是与CHC直接抗病毒药物联合治疗的理想搭档。人们急切期待3期试验结果,因为它们应能极大地阐明alb-IFN在CHC治疗中的未来作用。