Peginterferon lambda-1a

Pegylated Type III Interferon (IFN Λ1)Rx: PrescriptionCompound: Approved

Also known as: BMS-914143, IFN-λ1a, LAMBDA, Lambda IFN, Pegasys Lambda, RG7011

Educational Only — Not medical advice. Consult a qualified clinician before using any peptide.

Summary

Peginterferon lambda-1a (pegylated IFN-λ1) is a type III interferon conjugated with polyethylene glycol to extend half-life. It was approved in Canada and elsewhere for COVID-19 treatment and has been studied extensively for chronic hepatitis B, hepatitis C, and delta virus infections. Its receptor is predominantly expressed in hepatocytes and epithelial cells, resulting in a more favorable tolerability profile than alpha interferons.

Mechanism of Action

Binds to the IL-28 receptor complex (IL-28Rα/IL-10Rβ), activating the JAK-STAT signaling pathway (TYK2/JAK1) to induce antiviral gene expression; has restricted receptor distribution compared to type I interferons, limiting systemic side effects while maintaining antiviral efficacy

Routes of Administration

Subcutaneous

Goals & Uses

  • Chronic hepatitis C (HCV) treatmentAntiviral / HepatologyModerate
  • Chronic hepatitis B (HBV) functional cureAntiviral / HepatologyModerate
  • COVID-19 treatment (outpatient)Antiviral / Infectious DiseaseHigh
  • Respiratory viral infections (influenza, RSV)Antiviral / RespiratoryLow
  • Chronic hepatitis delta virus (HDV) treatmentAntiviral / HepatologyModerate

Contraindications

  • Hypersensitivity to interferons or PEGImmunologicHigh
  • PregnancyPopulationHighPotential fetal risk or insufficient safety data
  • Autoimmune hepatitisHepatic / AutoimmuneHigh
  • Decompensated liver diseaseHepatic ImpairmentHigh
  • Severe psychiatric disorders (untreated)PsychiatricHigh

Adverse Effects

  • Elevated liver enzymes (ALT/AST flares)HepaticUncommon
  • Injection site reactionsLocalCommon
  • HeadacheNeurologicCommonPain in the head or upper neck
  • NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
  • Depression / Mood changesPsychiatricUncommon
  • FatigueGeneralCommonLow energy or tiredness

Drug Interactions

  • Immunosuppressants (e.g., azathioprine, cyclosporine)Moderate
  • Myelosuppressive agents (e.g., chemotherapy)Moderate
  • CYP450 substrates (narrow therapeutic index)Low
  • RibavirinModerate

Population Constraints

  • Pediatric patients (<18 years)AgeRelative
  • Elderly (≥65 years)GeriatricRelative
  • BreastfeedingReproductiveRelative
  • Renal impairment (severe)RenalRelative

Regulatory Status

  • European UnionInvestigationalUnder EMA evaluation for HDV; orphan drug designation granted for hepatitis delta
  • United StatesInvestigationalNot FDA-approved; studied under IND for COVID-19, HDV, and HBV. Received Breakthrough Therapy Designation for HDV. FDA declined to authorize EUA for COVID-19 following TOGETHER trial.
  • United KingdomUnknownNo MHRA approval as of early 2024; investigational status for viral hepatitis and COVID-19

Approved in Canada (2023) under the brand name Pegasys Lambda for COVID-19 outpatient treatment. Under regulatory review or investigational in other jurisdictions including the US. Has orphan drug designations for HDV in the US and EU. Not FDA-approved as of early 2024.

Evidence & Sources

No sources recorded yet.

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