Peginterferon alfa-2a: Difference between revisions

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			{{Short description\|Pharmaceutical drug}}
	{{Primary sources\|date=November 2008}}
			{{Use dmy dates\|date=March 2024}}
	{{Drugbox
			{{Infobox drug
	\| Verifiedfields = changed		\| Verifiedfields = changed
	\| verifiedrevid = ~~408518025~~		\| verifiedrevid = 458269040
	\| ~~IUPAC_name~~ =		\| image =
			\| width =
			\| alt =
			\| caption =

	<!--Clinical data-->		<!-- Clinical data -->
	\| ~~tradename~~ =		\| pronounce =
			\| tradename = Pegasys, others
	\| Drugs.com = {{drugs.com\|CDI\|peginterferon_alfa-2a}}
			\| Drugs.com = {{drugs.com\|ppa\|peginterferon-alfa-2a}}
	\| MedlinePlus = a605029		\| MedlinePlus = a605029
			\| DailyMedID = Peginterferon_alfa-2a
	\| pregnancy_category =
	\| ~~legal_status~~ =		\| pregnancy_AU = B3
			\| pregnancy_AU_comment =
	\| routes_of_administration = subcutaneous
			\| pregnancy_category =

			\| routes_of_administration = ]
	<!--Pharmacokinetic data-->
	\| ~~bioavailability~~ =		\| class =
	\| metabolism =
	\| excretion =

	<!--Identifiers-->
	\| ChemSpiderID_Ref = {{chemspidercite\|changed\|chemspider}}
	\| ChemSpiderID = NA
	\| CAS_number_Ref = {{cascite\|correct\|??}}
	\| CAS_number = <!-- blanked - oldvalue: 215647-85-1 -->
	\| ATC_prefix = L03		\| ATC_prefix = L03
	\| ATC_suffix = AB11		\| ATC_suffix = AB11
	\| ATC_supplemental = <br>{{ATC\|L03\|AB61}} (in combinations)		\| ATC_supplemental = <br />{{ATC\|L03\|AB61}} (in combinations)

			<!-- Legal status -->
			\| legal_AU = S4
			\| legal_AU_comment =
			\| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F -->
			\| legal_BR_comment =
			\| legal_CA = <!-- OTC, Rx-only, Schedule I, II, III, IV, V, VI, VII, VIII -->
			\| legal_CA_comment =
			\| legal_DE = <!-- Anlage I, II, III or Unscheduled -->
			\| legal_DE_comment =
			\| legal_NZ = <!-- Class A, B, C -->
			\| legal_NZ_comment =
			\| legal_UK = POM
			\| legal_UK_comment =
			\| legal_US = Rx-only
			\| legal_US_comment =
			\| legal_EU = Rx-only
			\| legal_EU_comment = <ref>{{cite web \| title=Pegasys EPAR \| website=European Medicines Agency (EMA) \| date=20 June 2002 \| url=https://www.ema.europa.eu/en/medicines/human/EPAR/pegasys \| access-date=5 September 2024}}</ref>
			\| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV -->
			\| legal_UN_comment =
			\| legal_status = Rx-only

			<!-- Pharmacokinetic data -->
			\| bioavailability =
			\| protein_bound =
			\| metabolism =
			\| metabolites =
			\| onset =
			\| elimination_half-life =
			\| duration_of_action =
			\| excretion =

			<!-- Identifiers -->
			\| index2_label = alfa-2b
			\| CAS_number_Ref = {{cascite\|correct\|CAS}}
			\| CAS_number = 198153-51-4
			\| CAS_number2_Ref = {{cascite\|correct\|CAS}}
			\| CAS_number2 = 215647-85-1
			\| CAS_supplemental =
			\| PubChem =
			\| IUPHAR_ligand =
	\| DrugBank_Ref = {{drugbankcite\|correct\|drugbank}}		\| DrugBank_Ref = {{drugbankcite\|correct\|drugbank}}
	\| DrugBank = DB00008		\| DrugBank = DB00008
	\| ~~UNII_Ref~~ = {{~~fdacite~~\|changed\|~~FDA~~}}		\| ChemSpiderID_Ref = {{chemspidercite\|changed\|chemspider}}
			\| ChemSpiderID = none
	\| UNII = <!-- blanked - oldvalue: Q46947FE7K -->
			\| UNII_Ref = {{fdacite\|correct\|FDA}}
			\| UNII = Q46947ZFE7K
			\| UNII2_Ref = {{fdacite\|correct\|FDA}}
			\| UNII2 = G8RGG88B68
	\| KEGG_Ref = {{keggcite\|correct\|kegg}}		\| KEGG_Ref = {{keggcite\|correct\|kegg}}
	\| KEGG = D02748		\| KEGG = D02748
			\| ChEBI_Ref =
			\| ChEBI =
	\| ChEMBL_Ref = {{ebicite\|changed\|EBI}}		\| ChEMBL_Ref = {{ebicite\|changed\|EBI}}
	\| ChEMBL = ~~<!-- blanked - oldvalue:~~ 1201560 ~~-->~~		\| ChEMBL = 1201560
	\| ~~chemical_formula~~ =		\| NIAID_ChemDB =
			\| PDB_ligand =
	\| C=860 \| H=1353 \| N=227 \| O=255 \| S=9
			\| synonyms =
	\| molecular_weight = 19241 g/mol (unpegylated)<br />40000 g/mol (pegylated)

			<!-- Chemical and physical data -->
			\| IUPAC_name =
			\| C=860 \| H=1353 \| N=227 \| O=255 \| S=9
	}}		}}
	'''] ] alfa-2a''' (pegylated with a branched 40 kDa PEG chain; commercial name '''Pegasys''') is an ] discovered at the pharmaceutical company ]; it has a dual mode of action - both antiviral and on the immune system. The addition of ] to the interferon, through a process known as ], enhances the ] of the interferon when compared to its native form.

			<!-- Definition and medical uses -->
	==Uses==
			'''Pegylated interferon alfa-2a''', sold under the brand name '''Pegasys''' among others, is medication used to treat ] and ].<ref name=Pro2017/> For hepatitis C it is typically used together with ] and cure rates are between 24 and 92%.<ref name=Pro2017/><ref>{{cite web\|title=Pegasys 135 mcg and 180 mcg solution for injection in pre-filled pen - Summary of Product Characteristics (SPC) - (eMC)\|url=https://www.medicines.org.uk/emc/medicine/32432\|website=www.medicines.org.uk\|access-date=12 January 2017\|url-status=live\|archive-url=https://web.archive.org/web/20170113131243/https://www.medicines.org.uk/emc/medicine/32432\|archive-date=13 January 2017}}</ref> For hepatitis B it may be used alone.<ref name=BNF69>{{cite book\|title=British national formulary : BNF 69\|date=2015\|publisher=British Medical Association\|isbn=9780857111562\|page=639\|edition=69}}</ref> It is given by ].<ref name=Pro2017>{{cite web\|title=Peginterferon Alfa-2a (Professional Patient Advice) - Drugs.com\|url=https://www.drugs.com/ppa/peginterferon-alfa-2a.html\|website=www.drugs.com\|access-date=12 January 2017\|url-status=live\|archive-url=https://web.archive.org/web/20170116181400/https://www.drugs.com/ppa/peginterferon-alfa-2a.html\|archive-date=16 January 2017}}</ref>
	This drug is approved around the world for the treatment of chronic ] (including patients with ] co-infection, ], 'normal' levels of ]) and has recently been approved (in the ], ], ] and many other countries) for the treatment of chronic ].

			<!-- Side effects and mechanism -->
	Peginterferon alfa-2a is a long acting interferon. Interferons are ] released in the body in response to ]. Interferons are important for fighting ] in the body, for regulating reproduction of ], and for regulating the immune system.{{Citation needed\|date=October 2009}}
			Side effects are common.<ref name=UW2017/> They may include headache, feeling tired, depression, trouble sleeping, hair loss, nausea, pain at the site of injection, and fever.<ref name=Pro2017/> Severe side effects may include ], ], ], or ].<ref name=Pro2017/> Use with ribavirin is not recommended during ].<ref name=Pro2017/> Pegylated interferon alfa-2a is in the ] family of medications.<ref name=Pro2017/> It is ] to protect the molecule from breakdown.<ref name=UW2017>{{cite web\|title=Peginterferon alfa-2a (Pegasys) - Treatment - Hepatitis C Online\|url=http://www.hepatitisc.uw.edu/page/treatment/drugs/peginterferon-alfa-drug\|website=www.hepatitisc.uw.edu\|access-date=12 January 2017\|url-status=live\|archive-url=https://web.archive.org/web/20161223133654/http://www.hepatitisc.uw.edu/page/treatment/drugs/peginterferon-alfa-drug\|archive-date=23 December 2016}}</ref>

			<!-- History and culture -->
	== Host genetic factors influencing treatment response ==
			Pegylated interferon alfa-2a was approved for medical use in the United States in 2002.<ref name=Pro2017/> It is on the ].<ref name="WHO21st">{{cite book \| vauthors = ((World Health Organization)) \| title = World Health Organization model list of essential medicines: 21st list 2019 \| year = 2019 \| hdl = 10665/325771 \| author-link = World Health Organization \| publisher = World Health Organization \| location = Geneva \| id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO \| hdl-access=free }}</ref>

			==Medical uses==
	For genotype 1 hepatitis C treated with ] or ] (brand names Pegasys or PEG-Intron) combined with ], it has been shown genetic polymorphisms near the human IL28B gene, encoding interferon lambda 3, are associated with significant differences in response to the treatment. This finding, originally reported in Nature <ref>{{cite journal\|title=Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance\|author=Ge D, Fellay J, Thompson AJ, ''et al.''\|journal=Nature \|year=2009 \|volume=461\|pages=399–401 \|pmid=19684573 \|doi=10.1038/nature08309\|issue=7262}}</ref>, showed genotype 1 hepatitis C patients carrying certain genetic variant alleles near the IL28B gene are more likely to achieve sustained virological response after the treatment than others. Later report from Nature <ref>{{cite journal\|title=Genetic variation in IL28B and spontaneous clearance of hepatitis C virus\|author=Thomas DL, Thio CL, Martin MP, ''et al.''\|journal=Nature \|year=2009 \|pmid=19759533 \|doi=10.1038/nature08463\|volume=461\|issue=7265\|pages=798–801}}</ref> demonstrated the same genetic variants are also associated with the natural clearance of the genotype 1 hepatitis C virus.
			This drug is approved around the world for the treatment of chronic ] (including people with ] co-infection, ], 'normal' levels of ]) and has recently been approved (in the ], ], ] and many other countries) for the treatment of chronic ]. It is also used in the treatment of certain T-cell lymphomas, particularly ].{{citation needed\|date=January 2023}}

			Peginterferon alfa-2a is a long acting interferon. Interferons are ] released in the body in response to ]. ]s are important for fighting ] in the body, for regulating reproduction of ], and for regulating the immune system.<ref>{{Cite web\|url=https://www.drugs.com/mtm/interferon-alfa-2a.html\|title=Interferon alfa-2a Uses, Side Effects & Warnings\|website=Drugs.com\|language=en\|access-date=10 January 2020}}</ref>
	==See also==

	* ]
			=== Host genetic factors===
	* ]

			For genotype 1 hepatitis C treated with pegylated interferon alfa-2a or ] combined with ], it has been shown that genetic polymorphisms near the human IL28B gene, encoding interferon lambda 3, are associated with significant differences in response to the treatment. This finding, originally reported in '']'',<ref>{{cite journal\|title=Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance \|vauthors=Ge D, Fellay J, Thompson AJ, etal \|journal=Nature \|year=2009 \|volume=461\|pages=399–401 \|pmid=19684573 \|doi=10.1038/nature08309\|issue=7262\|bibcode=2009Natur.461..399G \|s2cid=1707096 }}</ref> showed genotype 1 hepatitis C patients carrying certain genetic variant alleles near the IL28B gene are more likely to achieve sustained virological response after the treatment than others. Another report in Nature demonstrated the same genetic variants are also associated with the natural clearance of the genotype 1 hepatitis C virus.<ref>{{cite journal\|title=Genetic variation in IL28B and spontaneous clearance of hepatitis C virus \|vauthors=Thomas DL, Thio CL, Martin MP, etal \|journal=Nature \|year=2009 \|pmid=19759533 \|doi=10.1038/nature08463\|volume=461\|issue=7265\|pages=798–801\|pmc=3172006\|bibcode=2009Natur.461..798T }}</ref>

			== Manufacturing ==
			It is ] with a branched 40{{nbsp}}kg/mol PEG chain.<ref>{{cite journal \| vauthors = Rajender Reddy K, Modi MW, Pedder S \| title = Use of peginterferon alfa-2a (40 KD) (Pegasys) for the treatment of hepatitis C \| journal = Advanced Drug Delivery Reviews \| volume = 54 \| issue = 4 \| pages = 571–86 \| date = June 2002 \| pmid = 12052715 \| doi = 10.1016/s0169-409x(02)00028-5 }}</ref>

			== Society and culture ==
			=== Availability ===
			Peginterferon alfa-2a is manufactured under the brand name Pegasys. In 2021, ] sold the worldwide rights of Pegasys (excluding China and Japan) to zr pharma& GmbH (pharma&).<ref>{{cite web \| title=Pegasys (peginterferon alfa-2a) \| website=Genentech \| url=https://www.gene.com/patients/medicines/pegasys \| access-date=8 January 2023 \| archive-date=8 January 2023 \| archive-url=https://web.archive.org/web/20230108213950/https://www.gene.com/patients/medicines/pegasys \| url-status=dead }}</ref><ref>{{cite web\|title=Verzichtserklärung der Zulassung - Mittelfristig läuft Pegasys aus\|url=https://assets.cwp.roche.com/f/94122/x/2b0bc67a9f/mittelfristig-luft-pegasys-aus-original-1176.pdf\|website=www.roche.de (German)\|access-date=4 December 2021\|archive-date=4 December 2021\|archive-url=https://web.archive.org/web/20211204170553/https://assets.cwp.roche.com/f/94122/x/2b0bc67a9f/mittelfristig-luft-pegasys-aus-original-1176.pdf\|url-status=dead}}</ref><ref>{{cite web\|title=Pegasys (Peginterferon alfa-2a) langfristig weiterhin erhältlich\|url=https://assets.cwp.roche.com/f/94122/x/8f2de3daec/kurzmeldung-pegasys-bleibt-verfugbar.pdf\|website=Roche\|language=de\|access-date=4 December 2021\|archive-date=4 December 2021\|archive-url=https://web.archive.org/web/20211204170551/https://assets.cwp.roche.com/f/94122/x/8f2de3daec/kurzmeldung-pegasys-bleibt-verfugbar.pdf\|url-status=dead}}</ref><ref>{{cite web\|title=pharma& portfolio\|url=https://www.pharmaand.com/portfolio-rx\|website=zr pharma& GmbH \|access-date=4 December 2021}}</ref><ref name="Roche HYR 2021">{{cite web\|title=HALF-YEAR REPORT 2021, p.20\|url=https://www.roche.com/dam/jcr:7260c9fc-2310-4305-bc10-ca3cea0de87d/en/hy21e.pdf\|website=Roche\|access-date=4 December 2021\|archive-date=24 November 2021\|archive-url=https://web.archive.org/web/20211124190028/https://www.roche.com/dam/jcr:7260c9fc-2310-4305-bc10-ca3cea0de87d/en/hy21e.pdf\|url-status=dead}}</ref> In May 2022, Roche Australia transferred the sales and marketing of Pegasys to Echo Therapeutics Pty Ltd.<ref>{{cite web \| title=Pegasys \| website=Roche Australia \| url=https://www.roche-australia.com/en_au/products/pharmaceuticals/pegasys.html \| access-date=8 January 2023}}</ref>

			==Research==
			A ] sought to determine whether interferon alfa-2a could be used as a treatment for individuals with ]. They found no evidence of improved visual acuity with potential harm.<ref name="Reddy">{{cite journal \|vauthors= Reddy U, Krzystolik M \|title= Antiangiogenic therapy with interferon alfa for neovascular age-related macular degeneration \|journal=Cochrane Database Syst Rev \|volume=1 \|pages= CD005138 \|date=2006 \|issue= 1 \|pmid= 16437522\|doi= 10.1002/14651858.CD005138.pub2}}</ref>

	==References==		==References==
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	==External links==		==External links==
			{{Commons category\|Interferon-alpha 2a}}
	*
			*{{MeshName\|Pegasys}}
	*
	*
	* {{MeshName\|Pegasys}}


	{{Interferons}}		{{Interferons}}
			{{Immunostimulants}}
	{{DNA antivirals}}		{{DNA antivirals}}
	{{RNA antivirals}}		{{RNA antivirals}}
			{{Cytokine receptor modulators}}
			{{Portal bar \| Medicine \| Viruses }}
			{{Authority control}}

	]		]
			]
	]		]
			]

			]

			]
	{{antiinfective-drug-stub}}
			]
	{{antineoplastic-drug-stub}}

	]
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Latest revision as of 00:05, 5 September 2024

Pharmaceutical drug

Pharmaceutical compound

Peginterferon alfa-2a
Clinical data
Trade names	Pegasys, others
AHFS/Drugs.com	Professional Drug Facts
MedlinePlus	a605029
License data	US DailyMed: Peginterferon_alfa-2a
Pregnancy category	AU: B3
Routes of administration	Subcutaneous injection
ATC code	L03AB11 (WHO) L03AB61 (WHO) (in combinations)
Legal status
Legal status	AU: S4 (Prescription only) UK: POM (Prescription only) US: WARNINGRx-only EU: Rx-only In general: ℞ (Prescription only)
Identifiers
CAS Number	198153-51-4 alfa-2b: 215647-85-1
DrugBank	DB00008
ChemSpider	none
UNII	Q46947ZFE7K alfa-2b: G8RGG88B68
KEGG	D02748
ChEMBL	ChEMBL1201560
Chemical and physical data
Formula	C₈₆₀H₁₃₅₃N₂₂₇O₂₅₅S₉
Molar mass	19241.16 g·mol
(what is this?) (verify)

Pegylated interferon alfa-2a, sold under the brand name Pegasys among others, is medication used to treat hepatitis C and hepatitis B. For hepatitis C it is typically used together with ribavirin and cure rates are between 24 and 92%. For hepatitis B it may be used alone. It is given by injection under the skin.

Side effects are common. They may include headache, feeling tired, depression, trouble sleeping, hair loss, nausea, pain at the site of injection, and fever. Severe side effects may include psychosis, autoimmune disorders, blood clots, or infections. Use with ribavirin is not recommended during pregnancy. Pegylated interferon alfa-2a is in the alpha interferon family of medications. It is pegylated to protect the molecule from breakdown.

Pegylated interferon alfa-2a was approved for medical use in the United States in 2002. It is on the World Health Organization's List of Essential Medicines.

Medical uses

This drug is approved around the world for the treatment of chronic hepatitis C (including people with HIV co-infection, cirrhosis, 'normal' levels of ALT) and has recently been approved (in the EU, U.S., China and many other countries) for the treatment of chronic hepatitis B. It is also used in the treatment of certain T-cell lymphomas, particularly mycosis fungoides.

Peginterferon alfa-2a is a long acting interferon. Interferons are proteins released in the body in response to viral infections. Interferons are important for fighting viruses in the body, for regulating reproduction of cells, and for regulating the immune system.

Host genetic factors

For genotype 1 hepatitis C treated with pegylated interferon alfa-2a or pegylated interferon alfa-2b combined with ribavirin, it has been shown that genetic polymorphisms near the human IL28B gene, encoding interferon lambda 3, are associated with significant differences in response to the treatment. This finding, originally reported in Nature, showed genotype 1 hepatitis C patients carrying certain genetic variant alleles near the IL28B gene are more likely to achieve sustained virological response after the treatment than others. Another report in Nature demonstrated the same genetic variants are also associated with the natural clearance of the genotype 1 hepatitis C virus.

Manufacturing

It is pegylated with a branched 40 kg/mol PEG chain.

Society and culture

Availability

Peginterferon alfa-2a is manufactured under the brand name Pegasys. In 2021, Roche Pharmaceuticals sold the worldwide rights of Pegasys (excluding China and Japan) to zr pharma& GmbH (pharma&). In May 2022, Roche Australia transferred the sales and marketing of Pegasys to Echo Therapeutics Pty Ltd.

Research

A Cochrane Review sought to determine whether interferon alfa-2a could be used as a treatment for individuals with neovascular age-related macular degeneration. They found no evidence of improved visual acuity with potential harm.

References

"FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
"Pegasys EPAR". European Medicines Agency (EMA). 20 June 2002. Retrieved 5 September 2024.
^ "Peginterferon Alfa-2a (Professional Patient Advice) - Drugs.com". www.drugs.com. Archived from the original on 16 January 2017. Retrieved 12 January 2017.
"Pegasys 135 mcg and 180 mcg solution for injection in pre-filled pen - Summary of Product Characteristics (SPC) - (eMC)". www.medicines.org.uk. Archived from the original on 13 January 2017. Retrieved 12 January 2017.
British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 639. ISBN 9780857111562.
^ "Peginterferon alfa-2a (Pegasys) - Treatment - Hepatitis C Online". www.hepatitisc.uw.edu. Archived from the original on 23 December 2016. Retrieved 12 January 2017.
World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
"Interferon alfa-2a Uses, Side Effects & Warnings". Drugs.com. Retrieved 10 January 2020.
Ge D, Fellay J, Thompson AJ, et al. (2009). "Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance". Nature. 461 (7262): 399–401. Bibcode:2009Natur.461..399G. doi:10.1038/nature08309. PMID 19684573. S2CID 1707096.
Thomas DL, Thio CL, Martin MP, et al. (2009). "Genetic variation in IL28B and spontaneous clearance of hepatitis C virus". Nature. 461 (7265): 798–801. Bibcode:2009Natur.461..798T. doi:10.1038/nature08463. PMC 3172006. PMID 19759533.
Rajender Reddy K, Modi MW, Pedder S (June 2002). "Use of peginterferon alfa-2a (40 KD) (Pegasys) for the treatment of hepatitis C". Advanced Drug Delivery Reviews. 54 (4): 571–86. doi:10.1016/s0169-409x(02)00028-5. PMID 12052715.
"Pegasys (peginterferon alfa-2a)". Genentech. Archived from the original on 8 January 2023. Retrieved 8 January 2023.
"Verzichtserklärung der Zulassung - Mittelfristig läuft Pegasys aus" (PDF). www.roche.de (German). Archived from the original (PDF) on 4 December 2021. Retrieved 4 December 2021.
"Pegasys (Peginterferon alfa-2a) langfristig weiterhin erhältlich" (PDF). Roche (in German). Archived from the original (PDF) on 4 December 2021. Retrieved 4 December 2021.
"pharma& portfolio". zr pharma& GmbH. Retrieved 4 December 2021.
"HALF-YEAR REPORT 2021, p.20" (PDF). Roche. Archived from the original (PDF) on 24 November 2021. Retrieved 4 December 2021.
"Pegasys". Roche Australia. Retrieved 8 January 2023.
Reddy U, Krzystolik M (2006). "Antiangiogenic therapy with interferon alfa for neovascular age-related macular degeneration". Cochrane Database Syst Rev. 1 (1): CD005138. doi:10.1002/14651858.CD005138.pub2. PMID 16437522.

External links

Pegasys at the U.S. National Library of Medicine Medical Subject Headings (MeSH)

Cell signaling: cytokines

By family

Chemokine

CCL	CCL1 CCL2/MCP1 CCL3/MIP1α CCL4/MIP1β CCL5/RANTES CCL6 CCL7 CCL8 CCL9 CCL11 CCL12 CCL13 CCL14 CCL15 CCL16 CCL17 CCL18/PARC/DCCK1/AMAC1/MIP4 CCL19 CCL20 CCL21 CCL22 CCL23 CCL24 CCL25 CCL26 CCL27 CCL28
CXCL	CXCL1/KC CXCL2 CXCL3 CXCL4 CXCL5 CXCL6 CXCL7 CXCL8/IL8 CXCL9 CXCL10 CXCL11 CXCL12 CXCL13 CXCL14 CXCL15 CXCL16 CXCL17
CX3CL	CX3CL1
XCL	XCL1 XCL2

TNF

Interleukin

Type I
(grouped by
receptor
subunit)

γ chain	IL2/IL15 IL4/IL13 IL7 IL9 IL21
β chain	IL3 IL5 GMCSF
IL6 like/gp130	IL6 IL11 IL27 IL30 IL31 +non IL OSM LIF CNTF CTF1
IL12 family/IL12RB1	IL12 IL23 IL27 IL35
Other	IL14 IL16 IL32 IL34

Type II

IL10 family

IL10/IL22
IL19
IL20
IL24
IL26
Interferon type III
- IL28/IFNL2+3
- IL29/IFNL1

Interferon

I	IFNA1 IFNA2 IFNA4 IFNA5 IFNA6 IFNA7 IFNA8 IFNA10 IFNA13 IFNA14 IFNA16 IFNA17 IFNA21 IFNB1 IFNK IFNW1
II	IFNG

Ig superfamily

IL17 family

IL17/IL25 (IL17A)

Other

By function/
cell

proinflammatory cytokine
- IL1
- TNFA

Monokine
Lymphokine
- T_h1
  - IFNγ
  - TNFβ
- T_h2
  - IL4
  - IL5
  - IL6
  - IL10
  - IL13

Immunostimulants (L03)

Endogenous

Cytokines

Colony-stimulating factors	G-CSF Efbemalenograstim alfa Eflapegrastim Filgrastim / Lipegfilgrastim / Pegfilgrastim Lenograstim GM-CSF Molgramostim Sargramostim SCF Ancestim
Interferons	alpha: Albinterferon Interferon alfa natural Interferon alfa 2a / Peginterferon alfa-2a Interferon alfa 2b / Peginterferon alfa-2b / Ropeginterferon alfa-2b Interferon alfa n1 Interferon alfacon-1 Interferon alpha-n3 feline "omega" beta: Interferon beta natural Interferon beta 1a Interferon beta 1b Interferon gamma
Interleukins	Aldesleukin Nogapendekin alfa inbakicept Oprelvekin

Other protein / peptide

Other

Exogenous

DNA virus antivirals (primarily J05, also S01AD and D06BB)

Baltimore I

Herpesvirus

DNA-synthesis
inhibitor

TK activated

Purine analogue

adenine (Vidarabine)

Pyrimidine analogue

thymine

cytosine (Cytarabine)

Not TK activated

Foscarnet

Other

HPV/MC

Vaccinia

assembly: Rifampicin

Poxviridae

Hepatitis B (VII)

Multiple/general

Nucleic acid inhibitors	Cidofovir Brincidofovir
Interferon	Interferon alfa 2b Peginterferon alfa-2a
Multiple/unknown	Filociclovir Ribavirin/Taribavirin Moroxydine

WHO-EM
Withdrawn from market
Clinical trials:
- Phase III
- Never to phase III

RNA virus antivirals (primarily J05, also S01AD and D06BB)

Hepatitis C

NS3/4A protease inhibitors (–previr)	Asunaprevir Boceprevir Ciluprevir Danoprevir Faldaprevir Glecaprevir Grazoprevir Narlaprevir Paritaprevir Simeprevir Sovaprevir Telaprevir Vaniprevir Vedroprevir Voxilaprevir
NS5A inhibitors (–asvir)	Coblopasvir Daclatasvir Elbasvir Ledipasvir Odalasvir Ombitasvir Pibrentasvir Ravidasvir Ruzasvir Samatasvir Velpatasvir
NS5B RNA polymerase inhibitors (–buvir)	Beclabuvir Bemnifosbuvir Dasabuvir Deleobuvir Filibuvir GS-6620 IDX-184 Setrobuvir Sofosbuvir Tegobuvir TMC-647055 Radalbuvir Uprifosbuvir
Combination drugs	Elbasvir/grazoprevir Glecaprevir/pibrentasvir Ledipasvir/sofosbuvir Ombitasvir/paritaprevir/ritonavir Sofosbuvir/daclatasvir Sofosbuvir/velpatasvir Sofosbuvir/velpatasvir/voxilaprevir

Hepatitis D

Bulevirtide

Picornavirus

viral entry: Pleconaril

Anti-influenza agents

Multiple/general

Interferon	Interferon alfa 2b Peginterferon alfa-2a Peginterferon alfa-2b
3CL protease inhibitors (–trelvir)	Atilotrelvir Ensitrelvir Ibuzatrelvir Lufotrelvir Nirmatrelvir (+ritonavir) Rupintrivir Simnotrelvir (+ritonavir)
RNA pol inhibitors	CMX521 Deuremidevir Favipiravir Galidesivir GS-441524 Remdesivir MK-608 Mericitabine Molnupiravir NITD008 Ribavirin Taribavirin Triazavirin Valopicitabine
Multiple/Unknown/Other	EICAR Merimepodib Moroxydine Presatovir

WHO-EM
Withdrawn from market
Clinical trials:
- Phase III
- Never to phase III

Cytokine receptor modulators

Chemokine

See here instead.

CSF

Erythropoietin	Agonists: ARA-290 Asialo erythropoietin Carbamylated erythropoietin CNTO-530 Darbepoetin alfa Epoetin alfa Epoetin beta Epoetin delta Epoetin epsilon Epoetin gamma Epoetin kappa Epoetin omega Epoetin theta Epoetin zeta Erythropoietin (EPO) Erythropoietin-Fc Methoxy polyethylene glycol-epoetin beta (CERA/Mircera) Peginesatide Pegol sihematide (EPO-018B)
G-CSF (CSF3)	Agonists: Filgrastim Granulocyte colony-stimulating factor Lenograstim Leridistim Lipegfilgrastim Nartograstim Pegfilgrastim Pegnartograstim
GM-CSF (CSF2)	Agonists: Ecogramostim Granulocyte macrophage colony-stimulating factor Milodistim Molgramostim Regramostim Sargramostim Antibodies: Mavrilimumab Namilumab Otilimab
M-CSF (CSF1)	Agonists: Cilmostim Interleukin-34 Lanimostim Macrophage colony-stimulating factor Mirimostim Kinase inhibitors: Agerafenib
SCF (c-Kit)	See here instead.
Thrombopoietin	Agonists: Eltrombopag Pegacaristim Promegapoietin Romiplostim Thrombopoietin (THPO, MGDF)

Interferon

IFNAR (α/β, I)

Decoy receptors: Bifarcept

IFNGR (γ, II)

Agonists: Interferon gamma (IFN-γ)
Interferon gamma 1b

Antibodies: Emapalumab
Fontolizumab

IFNLR (λ, III)

See IL-28R (IFNLR) here instead.

Interleukin

See here instead.

TGFβ

See here instead.

TNF

See here instead.

Others

JAK
(inhibitors)

JAK1	Abrocitinib Baricitinib Deuruxolitinib Filgotinib Momelotinib Oclacitinib Peficitinib Ruxolitinib Tofacitinib (tasocitinib) Upadacitinib
JAK2	Atiprimod AZD-1480 Baricitinib CHZ868 Cucurbitacin I (elatericin B, JSI-124) CYT387 Deuruxolitinib Lestaurtinib NSC-7908 NSC-33994 Pacritinib Peficitinib Ruxolitinib SD-1008 Tofacitinib (tasocitinib)
JAK3	Cercosporamide Decernotinib (VX-509) Peficitinib Ritlecitinib TCS-21311 Tofacitinib (tasocitinib) WHI-P 154 ZM-39923 ZM-449829
TYK2	Deucravacitinib

Others

Additional cytokines: Cardiotrophin 1 (CT-1)
FMS-like tyrosine kinase 3 ligand (FLT3L)
Leukemia/leukocyte inhibitory factor (LIF)
Oncostatin M (OSM)
Thymic stromal lymphopoietin (TSLP)

Additional cytokine receptor modulators: Emfilermin
Lestaurtinib
Midostaurin
Quizartinib
Sorafenib
Sunitinib

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