I am still waiting to receive my meds so I can start treatment. My hepatologist prescribed Pegasys and ribavirin which seems to be pretty standard. Well, my insurance company approved Pegintron instead of Pegasys because it's "preferred" under my plan. I'm not sure, but it's possible my Dr. will appeal their decision which adds another 3 wks. of waiting. I am wondering if there's a difference? I know this has been asked a bizillion times, however, I wasn't able to find a recent comparison.
Thanks for your help!
I know Pegasys is peginterferon alfa-2a & Pegintron is Peginterferon alfa-2b.
The "About" site says there is a slight difference in dosing. Not sure about side effect profile. There are a few links that compare the two & SVR on the bottom.
About web site:
The main difference between these two pegylated interferons is in the dosing.
Alfa-2a is used as a fixed weekly dose. Alfa-2b is used as a weekly dose based on the weight of the patient. There are other differences between the two drugs, but they are mostly technical and are used by the prescribing physician. For example, alfa-2a has a relatively constant absorption after injection and is distributed mostly in the blood and organs. But alfa-2b has a rapid absorption and a wider distribution in the body.
Until January 2008, no data directly compared these two medicines. That has changed with a large clinical study known as IDEAL. This should provide interesting results that will allow physicians additional insight into these powerful chronic hepatitis C therapies.
Here are some articles and links:
NE Journal of Medicine: Peginterferon Alfa-2b or Alfa-2a with Ribavirin for Treatment of Hepatitis C Infection
(the rates of sustained virologic response and tolerability did not differ significantly)
Peginterferon alpha-2a is associated with higher sustained virological response than peginterferon alfa-2b in chronic hepatitis C: systematic review of randomized trials
Peg-interferon alpha-2a versus Peg-interferon alpha-2b in nonresponders with HCV active chronic hepatitis: a pilot study.
(nonstatistically significant differences)
My experience was that Pegasys was much much easier to tolerate than was Peg-Intron. I treated with both interferons and Pegasys was literally a walk in the park compared to Peg-Intron. I think the efficacy is pretty much equal with Pegasys perhaps having a slight edge. It was the tolerability of Pegasys that enabled me to extend my treatment duration and achieve SVR.
As usual insightful info. from Mike(hello Mike) and just to add something that might be helpful
While they have slightly different mechanisms of action ,there are conflicting reports which one may be better
Most knowledgeable doctors treating HCV concur that overall there is very little difference in the rates of success.
While logic might lead one to assume that a dosage customized for each individual would deliver safer and more effective results, the data does not completely support this view. The conflicting evidence already in existence clearly indicates that more adequately funded, large, impartial, well-designed studies comparing the two pegylated interferons are needed. Since the differences between Pegasys and PegIntron appear to be negligible, those doing combination therapy for the first time have little reason to be concerned about which pegylated interferon their physician has prescribed.
The biggest difference is their pegylation. Pegsys' branched PEG attachment makes for a larger molecule and a more constant level in the blood. Tiny Peg-Intron is good for all those hard to reach places.
. Like mikesimon, I found PegIntron much harder on my system than Pegasys. When I treated with Pegasys I hardly noticed the flu-like symptoms. My first weeks were a breeze. In fact I had incredible energy boost the day after shot day. Fast forward several years to PegIntron. I finally knew what people were talking about with flu-like symptoms and feeling really bad. But, the fact was that I relapsed with Pegasys and the doctor wanted me to do PegIntron. So far, it looks like PegIntron has been successful. (I am currently waiting for the results from my 6-month post VL test, but previous tests have been undetectable).
I would not worry if the doctor cannot get the rx changed. Funny -- my insurance company's preferred drug was the Pegasys and we had to get special authorization to use the PegIntron
A forum member told me it could be that I had more interferon in my system on some days than others with the PegIntron and that it was due to the molecule size as desrt pointed out.
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