Duration Of Interferon Treatment Research Articles

Association of chronotype and timing of interferon injection with severity of IFNβ-induced flu-like syndrome in Multiple sclerosis (MS) patients

BackgroundAlthough Interferon-beta (IFNβ) has long been approved as a disease-modifying therapy (DMT) for Multiple sclerosis (MS), flu-like syndrome (FLS) persists as a common adverse effect of interferon therapy. Given the importance of circadian rhythm in regulating physiological processes, we aimed to assess the relationship between patient’s chronotype and time of interferon injection with FLS score in MS patients receiving IFNβ. MethodsA cross-sectional study was conducted on 118 MS patients who were referred to the clinic of neurology of Zanjan Vali-e-Asr Hospital for interferon injection. The included were invited to complete a morningness-eveningness questionnaire (MEQ) assessing patients’ chronotype. The following data were extracted from patients’ record: age, gender, duration of interferon treatment, type of interferon taken, time of interferon injection (morning/evening), FLS score, MS subtype, and usage of pain killers. All data found were imported and statistically analyzed in SPSS ver.26. ResultsAccording to the patients’ record, 114 (96.6%) patients had experienced post-interferon injection FLS with different severities. Statistical analysis revealed no significant relationship between the patient’s chronotype and FLS score. Nevertheless, the FLS score was significantly higher in those who had evening injections. ConclusionsTime of interferon injection was significantly associated with FLS score, with higher FLS score following evening injection. However, no significant relationship was found between the FLS score and the patient’s chronotype. It is recommended that further studies assessing circadian rhythm using laboratory tests such as melatonin measurement need to be undertaken to investigate the association of circadian rhythm with post-interferon injection FLS.

Retinopathy Associated with Adjuvant Interferon in a Patient with Malignant Melanoma: A Case Report and Review of the Literature

Interferons are kinds of proteins with immuneregulatory, antiviral and anti-proliferative functions. Interferons are widely used worldwide for the treatment of many diseases including cancer, hepatit C and immune mediated disease such as multiple sclerosis. Long-term use of interferons have some side effects. However, interferons have ophthalmologic side effects. Ocular toxicity may occur at any time during treatment. There is no association between the dose or duration of interferon treatment and ocular toxicity. Although visual acuity returns to normal in most patients when interferon is discontinued, vision loss may be permanent.

Interferon Treatment Duration in Patients With Chronic Delta Hepatitis and its Effect on the Natural Course of the Disease.

Interferon is the only treatment option in chronic delta hepatitis (CDH). A CDH database (333 patients, 161 with interferon treatment history) was analyzed for effects of treatment duration on virologic response and clinical outcomes. Ninety-nine CDH patients who received at least 6 months of interferon were selected. Maintained virologic response (MVR) was defined as hepatitis D virus RNA negative for 2 years after treatment discontinuation. Cumulative median interferon treatment duration was 24 months (range 6-126 months), with a median of 2 courses (range 1-8). Post-treatment median follow-up was 55 months (24-225 months). Thirty-five patients achieved MVR. Cumulative probability of MVR increased with treatment duration and reached 50% at 5 years. Patients with MVR were less likely to die from liver disease or develop complications compared to patients without MVR (P = .032, P = .006, respectively). Cirrhosis at baseline and no response to therapy (odds ratio 16.1 and 5.23, respectively) predicted an adverse endpoint. Hepatitis B surface antigen clearance occurred in 37% of patients with MVR. Viral response to interferon increases with treatment duration and favorably affects the natural course of disease. Interferon treatment duration has to be individualized with careful post-treatment assessment.

Adjuvant Antiangiogenic Treatment for Aggressive Giant Cell Lesions of the Jaw: A 20-Year Experience at Massachusetts General Hospital

To document long-term outcomes using a standardized treatment protocol of enucleation with preservation of vital structures and adjuvant subcutaneous interferon for aggressive giant cell lesions (GCLs) of the jaws. A retrospective cohort study was designed. We evaluated all patients treated at Massachusetts General Hospital from April 1995 through September 2015 by enucleation with preservation of vital structures and adjuvant daily subcutaneous interferon for aggressive GCLs. The sample included patients with complete medical records consisting of clinical, radiographic, histopathologic, and follow-up data. The exclusion criteria included patients with incomplete records, contraindications to interferon therapy, non-aggressive GCLs, and GCLs associated with syndromes or with hyperparathyroidism. The primary outcome variable was long-term progression-free survival (PFS). The secondary outcome variables were adverse effects and laboratory abnormalities classified by type, frequency, and severity. Predictor variables for recurrence or failure included age, gender, location and features of lesion, type of procedure, duration of interferon treatment, amount of bone fill at end of treatment, and adverse effects. Descriptive statistics, Kaplan-Meier survival analysis, and Cox proportional hazards regression analysis were computed. Of a total of 77 patients, 45 (mean age, 18.8 ± 12.5years; 29 female patients; 36 in whom the mandible was affected) met the inclusion criteria. The mean duration of interferon therapy was 7.9 ± 2.3months. After follow-up of 4.8 ± 3.9years, 6 patients showed progression of the lesion, considered recurrence (13.3% failure rate, 82.6% PFS rate). Most patients had mild (n= 42; 93.3%) and/or moderate (n= 31; 68.8%) side effects, which were readily managed. Adverse effects required stoppage of interferon in 7 patients, whereas no patients had long-term toxicity. No variable was significantly associated with PFS. The results of this study indicate that enucleation with preservation of vital structures in combination with adjuvant interferon alfa is a reliable treatment for aggressive GCLs of the jaws associated with a low recurrence rate.

Four Weeks Administration Schedule of Ropeginterferon Alfa-2b (AOP2014/P1101) in Polycythemia Very Patients Allows Maintaining of Efficacy with Favorable Toxicity Profile in the Phase I/II Peginvera Stud

Four Weeks Administration Schedule of Ropeginterferon Alfa-2b (AOP2014/P1101) in Polycythemia Very Patients Allows Maintaining of Efficacy with Favorable Toxicity Profile in the Phase I/II Peginvera Stud

Development of a murine animal model of depression for repeated dosing with human interferon alpha

Background:Neuropsychiatric adverse effects of interferon (IFN) alpha are well known. There is little clinically relevant research on animal models of depression with recombinant human IFN alpha 2b (rhIFN-α2b).Aim:To identify an appropriate dose and duration of administration of recombinant human interferon alpha-2b (rhIFN-α2b) to establish a convenient and clinically relevant murine model of chronic rhIFN-α2b-induced depression using the forced swim test (FST).Materials and Methods:Using a 4×3 factorial design, rhIFN-α2b was administered subcutaneously to mice (n=180) in the dose range of 400, 800, and 1600 IU/g/day for 5, 10, and 15 days; saline-treated mice formed the control groups. In each group, 1 day after the last dose, the mice were assessed for immobility in the FST. In another experiment, at these same doses and time points, the effect of rhIFN-α2b on murine motility was assessed in the small open field.Results:We found that rhIFN-α2b significantly increased immobility in the FST. The immobility was detectable by day 5 and did not increase with duration of IFN treatment. The immobility was apparent with the 400 IU/g/day dose and was not greater at higher IFN doses. At no dose or time point did rhIFN-α2b alter murine motility in the small open field.Conclusion:We conclude that rhIFN-α2b-induced behavioral despair, represented by immobility in the FST, is not due to reduced basal motility. The FST may therefore be used as a convenient Swiss albino mouse model of chronic rhIFN-α2b-induced depression with a 400–1600 IU/g/day dose administered subcutaneously for 5–15 days. The most economical model is 400 IU/g/day administered for 5 days

Effect of the Dose and Duration of Interferon-Alpha Therapy on the Incidence of Hepatocellular Carcinoma in Noncirrhotic Patients with a Nonsustained Response to Interferon for Chronic Hepatitis C

Objective: We evaluated the effect of dose and duration of treatment with interferon (IFN)-α on the incidence of hepatocellular carcinoma (HCC) after IFN treatment in patients with chronic hepatitis C. Methods: A total of 291 noncirrhotic patients with chronic hepatitis C without hepatitis B virus coinfection in whom hepatitis C virus (HCV) was not eradicated by IFN-α therapy were retrospectively analyzed. The incidence of HCC after IFN therapy was compared according to the total dose or duration of treatment. Results: Patients were followed up for 6–117 months after the end of IFN treatment. The duration of IFN treatment (≦24 vs. >24 weeks) had no effect on the incidence of HCC. However, the incidence of HCC was significantly lower in patients who received >500 million units of IFN as a total dose than in patients who received ≦500 million units of IFN (p = 0.0480), and the total dose of IFN (>500 million units) was an independent factor affecting the incidence of HCC (p = 0.0405). In addition, when focusing on patients whose histology was F2 or F3 before IFN treatment, the suppressive effect of the total dose of IFN (>500 million units) was emphasized (p = 0.0049 in generalized Wilcoxon test and p = 0.0178 in multivariate analysis). Conclusions: Patients with chronic hepatitis C should receive more than 500 million units of IFN when IFN is used to decrease the incidence of subsequent HCC.

Modulation of the co-promoting activity of gamma interferon in SENCAR and C57BL/6 mouse skin by difluoromethyllornithine and the scheduling and duration of interferon treatment

The murine skin multistage carcinogenesis model was used to characterize the co-promoting and tumor progressing activities of i.p. administered recombinant DNA-derived murine gamma interferon (rMuIFN-gamma). The dorsal skins of female SENCAR mice were topically initiated with 7,12-dimethylbenz[a]anthracene (DMBA) and promoted twice a week for 20 weeks with 1 microgram of 12-O-tetradecanoylphorbol-13-acetate (TPA). Doses of rMuIFN-gamma that had no effect on papilloma multiplicities when administered 1 day prior to TPA treatment increased the numbers of papillomas per mouse by 33-38% when administered immediately prior (zero time) to TPA application. A minimum of 6 weeks of co-treatment with TPA and rMuIFN-gamma (zero time) were necessary for demonstration of rMuIFN-gamma-dependent co-promotion. The ad libitum administration of either 0.25 or 1% (w/v) solutions of alpha-difluoromethylornithine (DFMO) in the drinking water inhibited by 90% the TPA-dependent elevation of epidermal ornithine decarboxylase activity but had minimal effect on papilloma multiplicities in TPA-promoted mice. However, both doses of DFMO completely suppressed rMuIFN-gamma-dependent co-promotion. Carcinoma incidence and multiplicities by weeks 46-48 of the promotion-progression period were statistically indistinguishable for initiated mice treated with TPA, TPA + DFMO, TPA + IFN-gamma or TPA + DFMO + IFN-gamma. Similarly, i.p. administration of rMuIFN-gamma to papilloma-bearing mice in a tumor progression study, with and without simultaneous topical TPA treatment, did not affect carcinoma latency or carcinoma multiplicities. C57BL/6 mice initiated with DMBA developed few papillomas (0.2 paps/mouse) after 19 weeks of TPA promotion. The i.p. administration of rMuIFN-gamma to C57BL/6 mice at the time of TPA treatment, at doses that were co-promoting in SENCAR mice, did not increase papilloma multiplicities. Collectively, our studies suggest that the co-promoting activity of rMuIFN-gamma is exceptionally sensitive to inhibition by DFMO and dependent upon the scheduling and duration of rMuIFN-gamma treatment, and the mouse strain/stock employed for the studies.

Modification of Hepatitis B Virus Infection by Recombinant Leukocyte Alpha A Interferon

A defect in alpha interferon production in patients with chronic type B hepatitis offers a rationale principle for treating this disease with interferon. Two trials with interferon in chronic type B hepatitis indicate that this therapy achieves an elimination of HBsAg and HBeAg significantly higher than spontaneous. Our study and that of others indicate, however, that the response to interferon therapy is dependent on many variables including: the type of interferon, the interferon dose, duration of interferon treatment, sex, sexual preference in men and coinfection with other viruses. As of the multiple modes of action of interferon, a better understanding of viral replication, of the antiviral action of interferon in hepatitis B virus (HBV) infection and of the immunomodulatory action of interferon in HBV infection will help to improve the treatment of chronic HBV infection with interferon.