The UK’s National Institute for Health and Clinical Excellence has given its backing to the use of Roche’s long-acting interferon alpha product Pegasys as a first-line treatment for patients with chronic hepatitis B.

NICE, which provides guidance on the treatments to be provided under the National Health Service in England and Wales, said that Pegasys (peginterferon alfa-2a) should be used in preference to short-acting forms of interferon alpha because it has clear advantages in terms of clinical efficacy and cost-effectiveness.

The agency said it had reviewed a number of comparative clinical trials which showed that patients are more likely to achieve lasting remission if they are treated with Pegasys compared to lamivudine and conventional interferon alpha.

It also backed use of the drug in both hepatitis B e antigen-positive and the hard-to-treat HBeAg-negative forms of the virus. The Scottish Medicines Consortium – NICE’s equivalent north of the border – gave a green light to Pegasys in hepatitis B last year.

The approval for Pegasys as first-line therapy for hepatitis B means that, in addition to improved lasting remission, patients will receive three times fewer injections compared to standard interferon and receive a shorter treatment duration than with lamivudine. The latter is especially significant as resistance to lamivudine occurs in more than 70% of cases after 5 years of treatment.

Hepatitis B is a highly contagious blood-borne virus that attacks the liver. Despite a highly effective vaccine, Roche claims that more than two billion people have been infected by HBV and 350 million people have chronic infection, which can be easily transmitted by blood-to-blood contact, during birth, sex, and by sharing needles.