Polyethylene glycol (PEG) moieties can be attached to proteins to improve their pharmacological
properties. Variables such as the molecular weight and conformation of PEG chains
have a bearing on the conjugate’s properties and should be considered when developing
pegylated proteins with desired characteristics. Recombinant interferon (IFN) alfa
has been used, with limited success, to treat patients infected with hepatitis C virus.
The recommended thrice-weekly administration of IFN alfa does not maintain sustained
plasma concentrations of the drug, thereby adversely affecting the potential virological
response. Pegylation alters the pharmacokinetic properties of IFN alfa and allows
for once-weekly administration. Pegylated IFNs contain either linear PEG chains of
small molecular weight, as is pegylated IFN alfa-2b (12 kD), or larger branched moieties,
as in pegylated IFN alfa-2a (40 kD). There are pharmacokinetic and pharmacodynamic
differences between the two IFNs. The much-increased sustained virological response
rates observed with pegylated IFN alfa-2a (40 kD) and pegylated IFN alfa-2b (12 kD)
support the rationale for pegylation of IFN.
KEYWORDS
Pegylated interferon - polyethylene glycol - hepatitis C - pharmacokinetics - pharmacodynamics
REFERENCES
- 1
Carithers Jr R L, Emerson S S.
Therapy of hepatitis C: meta-analysis of interferon alfa-2b trials.
Hepatology.
1997;
26
83S-88S
- 2
Keefe E B, Hollinger F B.
Group CIS. Therapy of hepatitis C: consensus interferon trials.
Hepatology.
1997;
26
101S-107S
- 3
McHutchison J G, Gordon S C, Schiff E R et al..
Interferon alfa-2b alone or in combination with ribavirin as initial treatment for
chronic hepatitis C.
N Engl J Med.
1998;
339
1485-1492
- 4
Poynard T, Marcellin P, Lee S S et al..
Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks
versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection
with hepatitis C virus.
Lancet.
1998;
352
1426-1432
- 5
Wills R J.
Clinical pharmacokinetics of interferons.
Clin Pharmacokinet.
1990;
19
390-399
- 6
Wills R J, Dennis S, Speigel H E, Gibson D M, Nadler P I.
Interferon kinetics and adverse reactions after intravenous, intramuscular, and subcutaneous
injection.
Clin Pharmacol Ther.
1984;
35
722-727
- 7
Chatelut E, Rostaing L, Gregoire N et al..
A pharmacokinetic model for alpha interferon administered subcutaneously.
Br J Clin Pharmacol.
1999;
47
365-371
- 8
Lam N P, Neumann A U, Gretch D R et al..
Dose-dependent acute clearance of hepatitis C genotype 1 virus with interferon alfa.
Hepatology.
1997;
26
226-231
- 9
Neumann A U, Lam N P, Dahari H et al..
Hepatitis C viral dynamics in vivo and the antiviral efficacy of interferon-alpha
therapy.
Science.
1998;
282
103-107
- 10
Zhi J, Teller S B, Satoh H, Koss-Twardy S G, Luke D R.
Influence of human serum albumin content in formulations on the bioequivalency of
interferon alfa-2a given by subcutaneous injection in healthy male volunteers.
J Clin Pharmacol.
1995;
35
281-284
- 11
Davis F F, Abuchowski A, Van Es T.
Enzyme-polyethylene glycol adducts: modified enzymes with unique properties.
Enzyme Engineering.
1978;
4
169-173
- 12
Reddy K.
Controlled-release, pegylation, liposomal formulations: new mechanisms in the delivery
of injectable drugs.
Ann Pharmacother.
2000;
34
915-923
- 13 Working P K, Newman M S, Johnson J et al.. Safety of poly(ethylene glycol) and
poly(ethylene glycol) derivatives. In: Harris JM, Zaplinsky S Poly(ethylene glycol):
Chemistry and Biological Applications. San Francisco, CA; American Chemical Society
1997: 45-59
- 14
Fuertges F, Abuchowski A.
The clinical efficacy of poly(ethylene glycol)-modified proteins.
J Control Release.
1990;
11
139-148
- 15
Delgado C, Francis G E, Fisher D.
The uses and properties of PEG-linked proteins.
Crit Rev Ther Drug Carrier Syst.
1992;
9
249-304
- 16
Shiffman M L.
Pegylated interferons: what role will they play in the treatment of chronic hepatitis
C?.
Curr Gastroenterol Rep.
2001;
3
30-37
- 17
Bailon P, Berthold W.
Polyethylene glycol-conjugated pharmaceutical proteins.
Pharm Sci Technol Today.
1998;
1
352-356
- 18
Harris J M, Martin N E, Modi M.
Pegylation: a novel process for modifying pharmacokinetics.
Clin Pharmacokinet.
2001;
40
539-551
- 19
Kozlowski A, Charles S A, Harris J M.
Development of pegylated interferons for the treatment of chronic hepatitis C.
BioDrugs.
2001;
15
419-429
- 20
Bailon P, Palleroni A, Schaffer C A et al..
Rational design of a potent, long-lasting form of interferon: a 40kDa branched polyethylene
glycol-conjugated interferon alpha-2a for the treatment of hepatitis C.
Bioconjugate Chem.
2001;
12
195-202
- 21
Algranati N E, Sy S, Modi M.
A branched methoxy 40 kDa polyethylene glycol (PEG) moiety optimizes the pharmacokinetics
(PK) of peginterferon a-2a (PEG-IFN) and may explain its enhanced efficacy in chronic
hepatitis C (CHC).
Hepatology.
1999;
30(suppl)
190A
- 22
Glue P, Fang J WS, Rouzier-Panis R et al..
Pegylated interferon-alpha2b: pharmacokinetics, pharmacodynamics, and preliminary
efficacy data.
Clin Pharmacol Ther.
2000;
68
556-567
- 23 Hoffman-La Roche .Complete product information: H Pegasys (peginterferon alfa-2a). Nutley,
NJ; Hoffman-La Roche revised December 2002
- 24
Xu Z-X, Patel I, Joubert P.
Single-dose safety/tolerability and pharmacokinetic/pharmacodynamics (PK/PD) following
administration of ascending subcutaneous doses of pegylated-interferon (PEG-IFN) and
interferon a-2a (IFN a-2a) to healthy subjects.
Hepatology.
1998;
28(suppl)
702A
- 25
Reddy K R, Wright T L, Pockros P J et al..
Efficacy and safety of pegylated (40-kd) interferon alpha-2a compared with interferon
alpha-2a in noncirrhotic patients with chronic hepatitis C.
Hepatology.
2001;
33
433-438
- 26
Zeuzem S, Feinman S V, Rasenack J et al..
Peginterferon alfa-2a in patients with chronic hepatitis C.
N Engl J Med.
2000;
343
1666-1672
- 27
Heathcote E J, Shiffman M L, Cooksley W G et al..
Peginterferon alfa-2a in patients with chronic hepatitis C and cirrhosis.
N Engl J Med.
2000;
343
1673-1680
- 28
Lindsay K L, Trepo C, Heintges T et al..
A randomised, double-blind trial comparing pegylated interferon alfa-2b to interferon
alfa-2b as initial treatment for chronic hepatitis C.
Hepatology.
2001;
34
395-403
K. Rajender ReddyM.D.
GI Division, 3 Ravdin, Hospital of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
eMail: rajender.reddy@uphs.upenn.edu