Page 62 - The Flying Publisher Guide to Hepatitis C Treatment

62 | Hepatitis C Treatment

therapeutic effects through the complementary roles of the two
types of cytokines (Pagliaccetti 2008). IFN-λ may be used to
target specific cell responses and to avoid the AEs of IFN-ɑs.
Interferon lambda has been pegylated (Zymogenetics/Bristol-
Myers Squibb); its administration in treatment-naive patients
chronically infected with HCV genotypes 1/2/3/4 resulted in
higher rates of RVR and EVR, which extended across all IL28B
host genotypes, and was associated with fewer hematologic
toxicities, flu-like and musculoskeletal symptoms compared with
PegIFNɑ-2a (Zeuzem 2011). IFN lambda might prove to be
increasingly important for the treatment of CHC, due to the
recent findings (see chapter 1) on the impact of host genetics in
the response to therapy (Tanaka 2010).

Albinterferon (Zalbin™, Human Genome Sciences) is a longer-
acting IFN, allowing for once or twice/month dosing schedule. It
consists of IFN alfa-2b genetically fused to recombinant human
albumin. Several unique features of albumin make it an ideal
candidate for integration into a drug-design platform, including
its unusually long half-life (~19 days), wide distribution,
negligible potential for confounding enzymatic or
immunological function and its physiological role as a carrier of
blood substances. The pharmacodynamic attributes of
albinterferon, which include the maintenance of viral
suppression across a longer dosing interval, might reduce viral
rebounds, while also improving patient’s compliance.
In phase III trials, in patients with genotype 1 CHC,
albinterferon (900 µg every 2 weeks) achieved noninferiority
compared with PegIFN alfa-2a, indicating that the two drugs are
equivalent (Nelson 2009). Albinterferon was also administered
with good results in combination with RBV in non-responders to
prior IFN therapy and is evaluated for the treatment of HIV/HCV
coinfected patients. However, the preliminary FDA evaluation
indicates that the licensing of this dosing regimen is unlikely,
due to the unfavorable risk-benefit profile, mainly caused by
slightly increased rates of serious pulmonary AEs, coughing and