Clinical Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2005; 11(12): 1769-1774
Published online Mar 28, 2005. doi: 10.3748/wjg.v11.i12.1769
Psychiatric side effects of pegylated interferon alfa-2b as compared to conventional interferon alfa-2b in patients with chronic hepatitis C
Michael R Kraus, Arne Schäfer, Herbert Csef, Michael Scheurlen
Michael R Kraus, Arne Schäfer, Herbert Csef, Michael Scheurlen, Medizinische Poliklinik, University of Würzburg, Department of Gastroenterology and Hepatology, Klinikstrasse 6 - 8, 97070 Würzburg, Germany
Author contributions: All authors contributed equally to the work.
Supported by an Unrestricted Grant From Essex Pharma (Munich, Germany), a subsidiary of Schering-Plough (Kenilworth NJ, USA)
Correspondence to: Michael R Kraus, M.D., Ph.D., Medizinische Poliklinik, University of Würzburg, Klinikstr 6 - 8, D-97070 Würzburg, Germany. kraus_m@klinik.uni-wuerzburg.de
Telephone: +49-931-201-70260 Fax: +49-931-201-70680
Received: August 20, 2004
Revised: August 21, 2004
Accepted: October 18, 2004
Published online: March 28, 2005
Abstract

AIM: To assess systematically the spectrum and extent of depressive symptoms comparing patient groups receiving peginterferon or conventional interferon.

METHODS: Ninety-eight patients with chronic hepatitis C and interferon-based therapy (+ribavirin) were consecutively enrolled in a longitudinal study. Patients were treated with conventional interferon alfa-2b (48/98 patients; 5 MIU interferon alfa-2b thrice weekly) or peginterferon alfa-2b (50/98 patients; 80-150 μg peginterferon alfa-2b) in combination with weight-adapted ribavirin (800-1200 mg/d). Repeated psychometric testing was performed before, three times during and once after antiviral therapy: Depression was evaluated by the Hospital Anxiety and Depression Scale (HADS), anger/hostility by the Symptom Checklist-90 Items Revised (SCL-90-R).

RESULTS: Therapy with pegylated interferon alfa-2b produces comparable scores for depression (ANOVA: P = 0.875) as compared to conventional interferon. Maximums of depression scores were even higher and cases of clinically relevant depression were frequent during therapy with peginterferon. Scores for anger/hostility were comparable for both therapy subgroups.

CONCLUSION: Our findings suggest that the extent and frequency of depressive symptoms in total are not reduced by peginterferon. Monitoring and management of neuropsychiatric toxicity especially depression have to be considered as much as in antiviral therapy with unmodified interferon.

Keywords: Pegylated interferon; Hepatitis C; Side effects; Depression; Interferon alfa