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Tapering off meds after 72 weeks
My doc agrees in theory that tapering off after 72 weeks seems to make sense, although there isn't any data to support it. There is data that suggests that going longer does increase the chance of svr. I'm on week 66 at 180mcg of peg, 1200mg of riba, plus 40,000 of procrit.
On week 73, I will reduce to 150mcg and 1000mg of riba.
Week 74, 135mcg and 800mg.
Week 75, 90mcg and 600mg.
Week 76, 45mcg and 400mg.
Week 77, 45mcg and 200mg.
The decision to do this is pretty simple for me, I tolerate the drugs with minimum sx. Not to mention that I forgot what it is like not taking shots and pills since I spent nearly 2 1/2 years of the last 3 years on treatment.
A little history, geno 1, 600,000 viral load, normal AST and ALT prior to 2003, cirrhosis with nodules, low platelets, enlarged spleen, varicies, enlarged lymph nodes, shunt around the spleen...blah blah blah. My 1st attempt I relapsed after 48 weeks, was undetectable at 12 weeks. I was undetectable at 1 month post treatment and detectable between 1 and 3 months post. Waited 6 months and started the 2nd attempt and was undetectable between week 8, 12, and 48. I hope this works and even if it doesn't, my liver got a couple years break and bought some time for something new to come to market.
On week 73, I will reduce to 150mcg and 1000mg of riba.
Week 74, 135mcg and 800mg.
Week 75, 90mcg and 600mg.
Week 76, 45mcg and 400mg.
Week 77, 45mcg and 200mg.
The decision to do this is pretty simple for me, I tolerate the drugs with minimum sx. Not to mention that I forgot what it is like not taking shots and pills since I spent nearly 2 1/2 years of the last 3 years on treatment.
A little history, geno 1, 600,000 viral load, normal AST and ALT prior to 2003, cirrhosis with nodules, low platelets, enlarged spleen, varicies, enlarged lymph nodes, shunt around the spleen...blah blah blah. My 1st attempt I relapsed after 48 weeks, was undetectable at 12 weeks. I was undetectable at 1 month post treatment and detectable between 1 and 3 months post. Waited 6 months and started the 2nd attempt and was undetectable between week 8, 12, and 48. I hope this works and even if it doesn't, my liver got a couple years break and bought some time for something new to come to market.
Kalio, I do remember HR but I missed his post on this subject. It makes a lot of sense to me. Do you happen to remember what subject that it is under?
I'm planning on doing the schedule that I posted above. My original and I believe is a better plan would be the plan above, but go 2 weeks of each reduction for the total of 10 weeks. My thought were that I relapsed between 1 and 3 months post treatment. I had to compromise with my doctor and wife. Who's life is it anyway?
Jim, I'm became undetectable between 8 and 12 weeks both times.
I'm planning on doing the schedule that I posted above. My original and I believe is a better plan would be the plan above, but go 2 weeks of each reduction for the total of 10 weeks. My thought were that I relapsed between 1 and 3 months post treatment. I had to compromise with my doctor and wife. Who's life is it anyway?
Jim, I'm became undetectable between 8 and 12 weeks both times.
I don't know if you were visiting here when HR used to post but he is a doctor/microbiologist/researcher and he believes that tapering off the drugs is an excellent idea. He does not agree that the drugs have a "built in" tapering system, that's a new one on me. He says that traditional SOC can potentially shock your immune system and that it is better to taper gradually off allowing your body to fill the void with producing it's own Interferon again. He says that using the injected interferon causes our bodies to produce less so tapering off and allowing a body chemistry adjustment is superior to the stop abrubtly system SOC uses. He wodered out loud a number of times about this because tapering is a simple thing to do and he says that the abrubt discontinuation of IFN in his view could contribute to a relapse.
What have you come up with as a plan? Cutting it down by 1/4 each week? Or?That is what I am thinking of doing, the 72 weeks of this tx is coming up soon for me and I have to decide how to go at it.
Let me know what you end up doing and how you reduce it. I've cut the Riba down some, I take 1,000 a day now down from 1400. But Im skittish about cutting the IFN!
What have you come up with as a plan? Cutting it down by 1/4 each week? Or?That is what I am thinking of doing, the 72 weeks of this tx is coming up soon for me and I have to decide how to go at it.
Let me know what you end up doing and how you reduce it. I've cut the Riba down some, I take 1,000 a day now down from 1400. But Im skittish about cutting the IFN!
Different Bill.
My thoughts for tapering off is that when most people relapse the viral load spikes even though there is a gradual taper when stopping normally. I'm hoping that my immune system takes over gradually with the help of the reducing dosage. Like I said there is no science behind it.
My thoughts for tapering off is that when most people relapse the viral load spikes even though there is a gradual taper when stopping normally. I'm hoping that my immune system takes over gradually with the help of the reducing dosage. Like I said there is no science behind it.
I'm assuming this is a different "Bill" from "Bill1954"? Just mentioned because some of the stats sound familiar.
In any event, you're probably aware that there is a built-in "taper" even if you stop each drug all at once as is the general convention. That's because each drug leaves your system gradually, with ribavirin in particular having a very long half life. What you're doing then, is simply slowing down the taper a little over a five week period. I asked my doctor something similar -- I treated 54 weeks -- and he said just stop everything at once. Like you say, no study data and somewhere in the back of my riba-paranoid mind was a voice that said, "you were RVR, so don't screw with the tx g*ds and screw things up". In other words, my fear was that tapering off might somehow allow the virus to gain a foothold again, however irrational that may be. I guess the question is why are you tapering off? If it's simply to extend treatment, then why not just treat five weeks longer? At least that's where I came out.
All the best,
-- Jim
In any event, you're probably aware that there is a built-in "taper" even if you stop each drug all at once as is the general convention. That's because each drug leaves your system gradually, with ribavirin in particular having a very long half life. What you're doing then, is simply slowing down the taper a little over a five week period. I asked my doctor something similar -- I treated 54 weeks -- and he said just stop everything at once. Like you say, no study data and somewhere in the back of my riba-paranoid mind was a voice that said, "you were RVR, so don't screw with the tx g*ds and screw things up". In other words, my fear was that tapering off might somehow allow the virus to gain a foothold again, however irrational that may be. I guess the question is why are you tapering off? If it's simply to extend treatment, then why not just treat five weeks longer? At least that's where I came out.
All the best,
-- Jim
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