What are the differences between high dose interferon versus pegylated interferon and which is more effective?

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KimMargolinMD (Physician - Oncology - Hematology/Oncology (Verified) ) - 08 / 06 / 2012

The main difference is that high-dose interferon is traditionally given with a 1-month induction period consisting of daily x 5/week intravenous infusions of the drug, followed by three-times-weekly self-administered injections under the skin for the ensuing 11 months. PEG-interferon is given as the weekly subcutaneous injections throughout the therapeutic period, which is intended to last for 5 years but may conclude earlier in the event of relapse or intolerance. The side effects of high-dose interferon are more severe during the induction period, when it is given in very high doses intravenously, and more tolerable during the period of thrice weekly injections under the skin. PEG-interferon is started at an initial moderate dose that is continued weekly for 8 weeks and followed by the maintenance dose, half as much as the induction dose, for the remainder of the 5 years of planned therapy. During the long-term treatment, side effects are comparable, in part because the dose of regular interferon may be lowered to manage side effects and keep them tolerable. The ability to reduce the chance of relapse is similar; in terms of enhancing survival, regular interferon has shown modest improvements in the overall patient groups, possibly more in some subgroups than others, while PEG-interferon has no overall impact on survival but has distinct benefits in well-defined subgroups which are currently being studied in greater detail (microscopic involvement of lymph node and ulceration of the primary melanoma).
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