Pegylated interferon for treating severe recurrent respiratory papillomatosis in a child: case report

Abstract

CONTEXT: Recurrent respiratory papillomatosis (RRP) is the most common laryngeal tumor. During childhood, it may present in extremely severe forms defined by the need for frequent surgical procedures to relieve respiratory distress and/or involvement of extralaryngeal sites such as lung involvement. Adjuvant therapies are indicated in these cases and interferon is one of the options. Pegylated interferon is more effective than conventional alpha interferon and, given its reported results in relation to treating hepatitis C over the past decade, we hypothesized that this might be more effective than conventional interferon also for treating respiratory papillomatosis. Use of a treatment strategy that eliminates the need for general anesthesia is particularly appealing, yet obtaining approval for use of medications that are not currently used for this purpose is challenging. CASE REPORT: We report the case of a child with severe RRP that had been followed for the preceding six years, who was treated with pegylated interferon after failure of other adjuvant therapies. There was noticeable improvement in the frequency of surgical procedures, which was regarded very receptively, considering the child's history and previous response to other therapies. CONCLUSION: Pegylated interferon may be a good option for diminishing the need for surgical intervention in severe cases of recurrent respiratory papillomatosis. IMedical Doctor and Associate Professor,

Parenteral Bevacizumab for the Treatment of Severe Respiratory Papillomatosis in an Adult Population

“…Biologic therapies have become much more common in recent decades for the management of both benign and malignant disease, providing promise for nonmalignant proliferative processes like RRP. Prior adjuvant therapies focused on the underlying biological processes influencing this disease, such as antivirals (cidofovir) and immune modulators (pegylated interferon), with some reported clinical benefit 23–26 . Certain treatments, such as interferons, are often poorly tolerated due to frequent dosing regimens and a significant side effect profile.…”

Infantile recurrent respiratory papillomatosis: review of adjuvant therapies

“…16 Some reports have indicated the need for tracheostomy, which is not unusual given the aggression of recurrent respiratory papillomatosis in this age group. [16][17][18] The risk of laryngeal scarring (anterior/posterior glottis, supraglottis or trachea) with CO 2 laser in children is well described. 16,19 None of the reviewed articles reported any longterm complications relating to the surgical technique in our intended age group.…”

“…It increases the half-life of the drug, reduces immunogenicity and improves the pharmacokinetics. It is significantly more effective than alpha-interferon at treating hepatitis C. 18 One case report is available relating to pegylated interferon. 18 A 14-month-old child with recurrent respiratory papillomatosis was treated with surgical debulking on a 2-weekly basis and required a tracheostomy.…”

“…It is significantly more effective than alpha-interferon at treating hepatitis C. 18 One case report is available relating to pegylated interferon. 18 A 14-month-old child with recurrent respiratory papillomatosis was treated with surgical debulking on a 2-weekly basis and required a tracheostomy. The child had no improvement with intralesional cidofovir and developed pulmonary papillomas at the age of three years.…”

Rezidivierende respiratorische Papillomatose: Aktuelles zu Diagnose und Therapie

“…Durch konstante Serumspiegel ist der verbesserte therapeutische Effekt bei limitierten Nebenwirkungen insbesondere in der Behandlung der Hepatitis C unterdessen gut belegt. In ersten Behandlungsversuchen scheint sich eine gute Wirksamkeit auch bei RRP zu zeigen [33].…”