Is PLEGRIDY another interferon? How might it be different from the interferons already used in the treatment of MS?
PLEGRIDY is pegylated interferon 1-a, the same active interferon molecule used in the branded drugs, Rebif and Avonex. Pegylation is the process of covalently attaching polyethylene glycol polymer chains to a protein, to increase its duration of action by slowly releasing the active molecule. This has been done with several other biological molecules used to treat other diseases like rheumatoid arthritis. Because of the pegylation process, PLEGRIDY only needs to be administered every 2 weeks by subcutaneous administration but with the usual interferon side effects. The clinical trial results with PLEGRIDY were nothing short of amazing for a first line therapy; the Advance study (PLEGRIDY clinical trial in relapsing MS) reported a 36 % reduction in relapse rate and a 38 % reduction in sustained disability progression over 1 year compared to placebo. There were also significant reductions in MRI activity and a very low rate of neutralizing antibody formation. The FDA is still reviewing the drug application for PLEGRIDY but I suspect it may replace most interferons as first line therapy if it is as well tolerated as reported and the costs are reasonable compared to other first line agents for MS.
Rip Kinkel, MD
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