Data about osteonecrosis

[drofi]

Does someone know published data about osteonecrosis caused by IFN treatment in other indications than leucaemia, eg hep traetment?

[drofi]

http://www.artsenapotheker.nl/c54947



Avascular necrosis with interferon alfa-2b in chronic myelogenous leukaemia



Australia - Out of a total of 426 reports involving interferon alfa-2b (Intron A®), the Adverse Drug Reaction Advisory Committee (ADRAC) has received six reports of avascular necrosis, aseptic necrosis or osteonecrosis in association with the treatment of chronic myelogenous leukaemia (CML). The site was the femoral or humoral head as identified by a bone scan or MRI. Daily doses varied from 3 to 10 million units, and the time to onset was 3-8 weeks.

Three cases of avascular necrosis of the femoral head in CML patients treated with interferon alfa have been described (1). All had thrombocytosis and loss of response (not described in the ADRAC reports). Avascular necrosis has occurred without interferon treatment in CML, but it has been exacerbated by interferon alfa treatment (1).

Since there appear to be no literature reports of avascular necrosis for interferon alfa in other indications (drofi: !!!!!), it was concluded that the avascular necrosis may be the result of an interaction between CML and interferon alpha therapy.

Interferon alfa can inhibit angiogenesis, which may cause avascular necrosis, and the stress of weight bearing may make the femoral head particularly vulnerable (2). The possibility of avascular necrosis should be considered if bone or joint pain develops in patients with CML given interferon alfa.



Extracted from Australian Adverse Drug Reactions Bulletin, Volume 24, Number 2, April 2005.



References

1. Kozuch P, Talpaz M, Faderl S, O'Brien S, Freireich EJ, Kantarjian H. Avascular necrosis of the femoral head in chronic myeloid leukaemia patients treated with interferon-alpha: a synergistic correlation? Cancer 2000 Oct 1; 89 (7):1482-9.

2. Smith DWE. Is avascular necrosis of the femoral head the result of inhibition of angiogenesis? Medical Hypotheses 1997; 49(6): 497-500.

[desrt]

Just one of many reasons IntronA is no longer state-of-the art and most of us take our IFN pegylated.

Signing off from McDonald's.

[drofi]

You did not read my posting carefully. The paper describes treatment of leukeamia, not hepatitis. Both diseases are unpleasant, but very different. While hepatitis causes thrombocytopenia very often, leukaemia caused thrombocytosis in the cases described in the australian paper. If you think these cases could have been avoided by using pegulated IFN insetad of IFN, you should have an idea "HOW" IFN causes osteonecrosis and why PEG-IFN could avoid this.

Statements like the one you have posted, telling opinions without any evidence for what is said, are a waste of time.

[desrt]

You would have better luck searching HIV forums. Much more "published data about osteonecrosis" and IFN there.



Vielen Gluck