Interferon Alfa-2B

Aka: Interferon Alfa-2B, Intron A, Interferon alfa, Interferon-alfa

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II. Indications

  1. Hepatitis C
    1. See Hepatitis C Treatment with Interferon and Ribavirin
    2. Replaced by other Hepatitis C Antiviral Regimens, with the exception of a few Genotypes
  2. Chronic Hepatitis B Infection
    1. Replaced by Peginterferon Alpha-2A
  3. Leukemia
    1. Hairy Cell Leukemia
    2. Chronic Myelogenous Leukemia
    3. Chronic granulocytic Leukemia
  4. Lymphoma
    1. Non-Hodgkin's Lymphoma
    2. Cutaneous T Cell Lymphoma
    3. Follicular Lymphoma
  5. Other Malignancy
    1. Kaposi Sarcoma
    2. Melanoma
    3. Superficial Bladder Cancer

III. Contraindications

  1. Decompensated Cirrhosis (Child-Pugh Class >=6)
  2. Autoimmune Hepatitis

IV. Mechanism

  1. Interferon is an endogenous Cytokine (integral to inflammatory and immune responses)
    1. Released from Lymphocytes, Dendritic Cells, Macrophages, fibroblasts, Natural Killer Cells and T Cells
  2. Interferon is subdivided into three main types (alpha, beta, gamma)
    1. Alpha and beta Interferon both have Antiviral activity
    2. Synthesized alpha Interferon has primarily been used for Viral Hepatitis B and C infection, as well as cancer
    3. Synthesized beta Interferon has primarily been used to treat Multiple Sclerosis
  3. Alpha Interferon binds cell-surface receptors on viruses and cancer cells
    1. Modulates transcription and translation of genes, inhibiting replication in virus infected cells
    2. Interferon Alpha-2B is a non-glycosylated recombinant Interferon that has Antiviral and antineoplastic activity

V. Dosing: Chronic Hepatitis BVirus

  1. Peginterferon Alpha-2A is preferred instead
  2. Adult
    1. Dose 5 MU SQ or IM daily OR for 16 weeks
    2. Dose 10 MU SQ or IM three times weekly for 16 weeks
  3. Child (age >=1 year)
    1. Start: 3 MU/m2 SQ three times per week for the first week, then
    2. Next: 6 MU/m2 (up to 10 MU) SQ three times weekly

VI. Efficacy

  1. Synergistic effect when combined with Ribavirin
  2. Sustained response in 10-30% of cases of Hepatitis B
  3. Poor response when coinfected with HIV
  4. Improved response rates with
    1. Low levels of Viremia
    2. Absence of Cirrhosis
    3. Early response to Interferon
    4. Low total body iron

VII. Adverse Effects

  1. Transient Flu-like symptoms (>50%)
    1. Fever and chills
    2. Headache
    3. Myalgia
    4. Nausea
    5. Diarrhea
  2. Early: Decreased cell lines (higher risk in HIV Infection)
    1. Decreased Granulocytes
    2. Thrombocytopenia
  3. Later
    1. Fatigue
    2. Major Depression
    3. Suicidality
    4. Alopecia
    5. Rash
    6. Retinal Hemorrhages
    7. Autoimmune Thyroid disease
    8. Hepatotoxicity
    9. Hypertriglyceridemia

VIII. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation

IX. Monitoring

  1. Initial flu-like symptoms
    1. Acetaminophen (Tylenol)
  2. Periodic labs
    1. Complete Blood Count (CBC)
      1. Decrease dosage or discontinue Interferon if Hemolytic Anemia
    2. Thyroid Stimulating Hormone (TSH)
    3. Liver Function Tests
      1. Discontinue Interferon if LFTs have not normalized by week 12
    4. Serum Triglycerides

X. Resources

  1. Interferon Alfa-2B (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=30789790-8317-49f9-b97b-8c5ba17b53d2

XI. References

  1. Lau (1997) Gastroenterology 113:1660-7 [PubMed]
  2. (1999) Med Lett Drugs Ther 41(1054):53-4 [PubMed]
  3. (2013) Med Lett Drugs Ther 11(127): 19-30 [PubMed]

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Related Studies

Ontology: Interferon-alpha (C0002199)

Definition (CHV) a protein produced by the body in response to an infection
Definition (CHV) a protein produced by the body in response to an infection
Definition (CHV) a protein produced by the body in response to an infection
Definition (CHV) a protein produced by the body in response to an infection
Definition (CHV) a protein produced by the body in response to an infection
Definition (CHV) a protein produced by the body in response to an infection
Definition (CSP) major interferon produced by virus-exposed leukocytes; has antiviral activity and activates NK cells; used in the treatment of hairy cell leukemia and other neoplasms.
Definition (PDQ) A class of naturally-isolated or recombinant therapeutic peptides used as antiviral and anti-tumor agents. Alpha interferons are cytokines produced by nucleated cells (predominantly natural killer (NK) leukocytes) upon exposure to live or inactivated virus, double-stranded RNA or bacterial products. These agents bind to specific cell-surface receptors, resulting in the transcription and translation of genes containing an interferon-specific response element. The proteins so produced mediate many complex effects, including antiviral effects (viral protein synthesis); antiproliferative effects (cellular growth inhibition and alteration of cellular differentiation); anticancer effects (interference with oncogene expression); and immune-modulating effects (natural killer cell activation, alteration of cell surface antigen expression, and augmentation of lymphocyte and macrophage cytotoxicity). Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40467&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40467&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C225" NCI Thesaurus)
Definition (MSH) One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells. In addition to antiviral activity, it activates NATURAL KILLER CELLS and B-LYMPHOCYTES, and down-regulates VASCULAR ENDOTHELIAL GROWTH FACTOR expression through PI-3 KINASE and MAPK KINASES signaling pathways.
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH D016898
SnomedCT 411113009, 45754009, 136111001
LNC LP18173-2, MTHU003526
English alpha Interferon, alpha-Interferon, Interferon Alfa, Interferon alpha, Interferon, alpha, Interferon, Leukocyte, Interferon, Lymphoblast, Interferon, Lymphoblastoid, alpha-interferon, Lymphoblast Interferon, Leukocyte Interferon, Lymphoblastoid Interferon, interferon alpha, leukocyte interferon, Interferon-alpha [Chemical/Ingredient], alpha interferons, interferon-alpha, alpha interferon, IFNa, Interferon alfa (substance), Interferon.alpha, interferon alfa, Alpha interferon, Interferon alfa (product), Interferon alfa, Alpha interferon (substance), interferon A, IFN-A, Interferon-alpha
Swedish Alfa-interferon
Czech interferon alfa, interferon lymfoblastický, interferon leukocytový, INFalfa
Finnish Alfainterferoni
French Interféron alfa, Interféron alpha leucocytaire, Interféron alpha lymphoblastique, IFN-alpha, alpha-Interféron, Interféron alpha
German Interferon-Alfa-n3, Alpha-Interferon, Interferon Alfa, Interferon, Leukozyten-, Interferon, Lymphoblasten-, Interferon-Alpha
Russian INTERFERON LIMFOBLASTOV, AL'FA-INTERFERON, INTERFERON LEIKOTSITOV, INTERFERON-AL'FA, INTERFERON AL'FA, INTERFERON AL'FA-2B, INTERFERON AL'FA-2A, REKOMBININTNYI INTERFERON AL'FA-2B, РЕКОМБИНИНТНЫЙ ИНТЕРФЕРОН АЛЬФА-2B, INTERFERON AL'FA-2C, REKOMBINANTNYI INTERFERON AL'FA-2A, РЕКОМБИНАНТНЫЙ ИНТЕРФЕРОН АЛЬФА-2A, ИНТЕРФЕРОН АЛЬФА-2C, ИНТЕРФЕРОН АЛЬФА-2C РЕКОМБИНИНТНЫЙ, ИНТЕРФЕРОН АЛЬФА-2A, ИНТЕРФЕРОН АЛЬФА-2B, INTERFERON AL'FA-2C REKOMBININTNYI, АЛЬФА-ИНТЕРФЕРОН, ИНТЕРФЕРОН АЛЬФА, ИНТЕРФЕРОН-АЛЬФА, ИНТЕРФЕРОН ЛЕЙКОЦИТОВ, ИНТЕРФЕРОН ЛИМФОБЛАСТОВ
Japanese インターフェロン-アルファ, インターフェロンアルフア, リンパ芽球インターフェロン, 白血球インターフェロン, インターフェロンα, インターフェロン-リンパ芽球, アルファインターフェロン, インターフェロン-白血球
Italian Alfa-interferone, Interferone alfa-n3, Interferone linfoblastoide, Interferone leucocitario, Interferone alfa
Polish Interferon limfoblastów, Interferon alfa, Interferon leukocytów, Interferon alfa 2c, INF alfa, Interferon alfa 2a, Interferon alfa-2b, Interferon alfa 2b, Interferon alfa-2a, Interferon alfa-2c
Croatian INTERFERON ALFA, INTERFERON-ALFA
Portuguese alfa-Interferon, Interferon alfa, Interferon de Leucócitos, Interferon de Linfoblastos
Spanish Interferón Linfoblastico, Interferón Leucocítico, alfa-Interferón, interferón alfa (sustancia), alfa interferón (sustancia), alfa interferón, interferón alfa (producto), interferón alfa, Interferón alfa
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Interferon Alfa-2b (C0021735)

Definition (NCI_NCI-GLOSS) A drug used to treat some infections caused by viruses and several types of cancer. These include hairy cell leukemia, melanoma, and follicular lymphoma. It is a form of interferon alfa (a substance normally made by cells of the immune system) that is made in the laboratory. It is a type of biological response modifier.
Definition (NCI) A non-glycosylated recombinant interferon with antiviral and antineoplastic activities. Alfa interferons bind to specific cell-surface receptors, resulting in the transcription and translation of genes whose protein products mediate antiviral, antiproliferative, anticancer, and immune-modulating effects.
Definition (PDQ) A non-glycosylated recombinant interferon with antiviral and antineoplastic activities. Alfa interferons bind to specific cell-surface receptors, resulting in the transcription and translation of genes whose protein products mediate antiviral, antiproliferative, anticancer, and immune-modulating effects. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=462279&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=462279&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1953" NCI Thesaurus)
Definition (PDQ) A non-glycosylated recombinant interferon alpha, subtype 2b, used as an antiviral and antineoplastic agent. Alpha interferons bind to specific cell-surface receptors, resulting in the transcription and translation of genes whose protein products mediate antiviral, antiproliferative, anticancer, and immune-modulating effects. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=448847&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=448847&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1953" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Immunologic Factor (T129)
MSH D015381 , C554127
SnomedCT 386915008, 108797002
Swedish Interferon alfa-2b
English IFN alpha-2B, recombinant interferon alfa-2b, interferon alpha-2b, interferon alfa-2B, INTERFERON ALFA-2B, Interferon Alfa-2B, alpha-2b interferon, alpha-2b interferon (medication), recombinant interferon alpha 2b, 2b alfa interferon, alfa-2b interferon, interferon alfa 2b, interferon alfa-2b,recomb., interferon alfa-2b, recombinant interferon alpha-2b, interferon alfa-2b [Chemical/Ingredient], Interferon alpha-2b, recombinant, IFNalpha-2b, recombinant, Interferon alfa-2b, Interferon alpha-2b (substance), Interferon alpha-2b preparation (product), Interferon alpha-2b preparation, Interferon alpha-2b, Interferon alpha-2b preparation (substance), Interferon Alfa-2b, Recombinant Interferon Alfa-2b, Interferon Alpha-2b, Interferon alfa 2b, INTERFERON ALFA 2-B, INTERFERON ALFA-2B,RECOMBINANT, Interferon Alfa-2b, Recombinant
Spanish preparado de interferón alfa - 2b, interferón alfa-2b (producto), preparado de interferón alfa-2b (producto), interferón alfa-2b, preparado de interferón alfa-2b, interferón alfa - 2b (sustancia), interferón alfa - 2b, preparado de interferón alfa - 2b (sustancia), preparado de interferón alfa-2b (sustancia)
Finnish Interferoni alfa-2b
Japanese インターフェロン-アルファ2b, 組換えインターフェロン-アルファ2b, インターフェロン-アルファ2b-組換え, インターフェロンα2b-組換え, インターフェロンα2b, 組換えインターフェロンα2b
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Intron A (C0751600)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
MSH C554127
English intron A, intron a, Intron A (Interferon), Intron A
Derived from the NIH UMLS (Unified Medical Language System)

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