Clinical

Pegylated interferon alpha does not cause peripheral neuropathy

Last Updated: 2006-09-28 16:01:59 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Treatment of hepatitis C virus (HCV) infection with pegylated interferon alpha (PEG-IFN) is not associated with the development or worsening of peripheral neuropathy, according to a report in the September Neurology.

"This is, to our knowledge, the first prospective study aimed to address the potential peripheral neurotoxicity of PEG-IFN," Dr. Chiara Briani from University of Padova, Venice, Italy told Reuters Health. "Given the worldwide diffusion of HCV infection, and the controversial data on possible side effects of alpha-IFN on the peripheral nervous system, we believe that the results of our prospective study provide useful information crucial for HCV infection management."

Dr. Briani and colleagues investigated whether PEG-IFN therapy in patients with chronic HCV would worsen or cause neuropathy and whether treatment would induce antibodies to peripheral nerve antigens.

PEG-IFN therapy of 52 patients for 3.6 to 15 months brought no significant differences in the clinical or electrophysiologic measures, the authors report, regardless of whether patients had polyneuropathy at baseline.

Similarly, neurologic and electrophysiologic evaluations for 2.5 to 22 months after discontinuation of PEG-IFN showed no significant changes, the results indicate.

Two patients, only one of whom received PEG-IFN, developed low level IgG antibodies to gangliosides during follow-up, the researchers note, but no patient had antibodies to sulfatides.

"From the results of our prospective study, alpha-IFN seems not to induce or worsen peripheral neuropathy in HCV patients," Dr. Briani said. "Still, we cannot exclude that individual as well as genetic factors may predispose to the development of neuropathy in some HCV-infected subjects, as reported by other authors."

"Care should be taken in carefully monitoring the patients who undergo alpha-IFN therapy, with a close electrophysiological follow-up, until possible predictors of the neurological response to alpha-IFN therapy are identified," Dr. Briani concluded.

Neurology 2006;67:781-785.