Hepatitis B Community
pegintf add on to nucs sum up
About This Community:

This forum is an un-mediated, patient-to-patient forum for questions and support regarding Hepatitis B. Topics in this forum include but are not limited to, Causes, Diagnosis, Family and Relationships, Living With Hepatitis B, Research Updates, Treatment, Success Stories, Support, Symptoms.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

pegintf add on to nucs sum up

http://www.aphc.info/pdf/2014/Luncheons_13012014/S-242A/Denis_OUZAN.pdf

from page 22 very interesting presentation of latest small trials on peg add on to longterm stable nucs

the hbsag loss depends mainly on the years on nucs therapy, the longer the better, best results over 6years of nuc and hbvdna und

use of etv or tdf should help gain response in less than 6 years but the number of patients is so small that no real conclusions can be made on this
Blank
Avatar_m_tn
This study has too low numbers for firm conclusions. What can be seen again is that the ongoing internal suppression, exemplified by low hbsag concentrations before the peg ifn start, is critical to achieve hbsag negativity.

The low virion production under nucs leads to a reduction of class II response and therefore less inflammation and pro fibrotic stimulation, hence the clinical improvement under nucs. At the same time, the constant overstimulation and exhaustion of cd8 T cells is reduced, leading to at least a partial recovery of HBV specific cd8 clones, this causes the improvement after waiting undetectible under nucs for years in the response to peg ifn.

The difference in antiviral efficacy using combos is small, the main virtue of combos is crossprotection from resistance. Nevertheless, there could be a difference in residual stimulatory power, as you suspect. The data available are however way too limited for a firm conclusion.

16 Comments Post a Comment
Blank
Avatar_m_tn
Excellent presentation. Dr Ouzan did the study on Peg add on that achieved very good HBsAg clearance.

Thanks.
Blank
Avatar_m_tn
Interesting.. Am I reading this right though 6year of  Interferon?
Blank
Avatar_m_tn
no all wrong, read it again carefully it is a easy schedule
Blank
Avatar_m_tn
I wonder, Are the years of NUC therapy important or the time with DNA und?
Blank
Avatar_m_tn
Read it in full nothing new leaping out at me just mainly suppression stuff... I  wonder once Replicor is on the market 3 maybe 4years time then hey this stuff won't seem that relevant but thank you for sharing Steff2011 Oh by the way the World Hep fund posted this on face book :)                                                                                                                                                                                                               https://www.************/photo.php?fbid=189327787944190&set=a.116189521924684.1073741826.114866245390345&type=1&theater
Blank
Avatar_m_tn
with replicor, myrcludex you just fasten the process but results are the same, going more than 90% response on hbsag is not that probable/meaningful

you wont see anything new on the market before 5-10 years so i dont think it is uselful to talk about these drugs anymore until they show results on patients or they really get to market, since the cure is available to all and it is slow it is best to cure hbv now by the sequential combo available
Blank
Avatar_m_tn
the years of hbvdna undetectable of course and very probable IP10 serum levels which can guide on the best time for pegintf add on, to see immediately those that can respond after 3 years and those needing 5-6 years

i hope dr Ouzan measured ip10 levels too or has frozen blood sample to continue research, i am sure ip 10 can help on this
Blank
Avatar_m_tn
Steff2011 they have results on patients already not just animal testing please see link http://www.replicor.com/debut_anglais2.htm

The world Hepatitis Fund are saying on face book potentially 3years not 5years like you said. Its very close :) .... I Think judging by the data so far on Replicor the clearance rate 8out of 9 patients...

As long as there is focus on it and talk about it the less its forgotten the better in my view...
Blank
Avatar_m_tn
Stef,

Could you explain a bit when you said "with replicor, myrcludex you just fasten the process but results are the same, going more than 90% response on hbsag is not that probable/meaningful"?

What do you mean more than 90% response on hbsag is not that probable or meaningful? Are you suggesting that 60% cure rate with Rep 9AC is the best we could expect, same level as current Nuc+Peg could achieve? I thought with Rep 9AC or Myrcludex we can reach 100% cure rate. thank you very much.
Blank
Avatar_m_tn
that on bigger trials you probably get close to 95% but it may not work on all patients.this is all to prove on bigger human trials yet we have very few patients on rep9ac and no data on myrcludex yet

the process is faster because hbsag drops in weeks while on sequential it takes many years
Blank
Avatar_m_tn
my message is we better not waste time and go for the sequential immediately if we can, since it takes so many years.

in the meantime it is very good to talk about myrcludex and rep9ac but it is best to start the drugs we have now, i have very little faith in the drug markets
Blank
Avatar_m_tn
Steff I'm thinking the same as you work with what we have. Weather people chose pharma meds herbs etc whatever.

But I also think its important that we give due attention to what is a more tolerable cure that works quicker. You know my opinion on Pharmas etc from previous posts on other topics....

It will just be nice to have something on the market that doesnt take a big chunk of our lives with not the best results with quite sever side effects

But di want to ask do you know the difference between Gama interferon & Peg Interferon?
Blank
Avatar_m_tn
Stef, thank you very much for your detailed explanations.
Blank
Avatar_m_tn
i have noticed some peg add on trials are been designed with nucs monotherapy.
do you think suppressing intrahepatic hbvdna too much can also lower immune response due to less virions?what about a staggered regimen with the second nuc?

in this study, although very small, nuc mono had much more response than combo nucs (if we assume hbsag level is not important once cd8 response is recovered)

https://drive.google.com/file/d/0B8E77QizhkLQa29tZ0xkaE5KWHBOVlR0OUIxejNQYWpuckIw/edit?usp=sharing
Blank
Avatar_m_tn
This study has too low numbers for firm conclusions. What can be seen again is that the ongoing internal suppression, exemplified by low hbsag concentrations before the peg ifn start, is critical to achieve hbsag negativity.

The low virion production under nucs leads to a reduction of class II response and therefore less inflammation and pro fibrotic stimulation, hence the clinical improvement under nucs. At the same time, the constant overstimulation and exhaustion of cd8 T cells is reduced, leading to at least a partial recovery of HBV specific cd8 clones, this causes the improvement after waiting undetectible under nucs for years in the response to peg ifn.

The difference in antiviral efficacy using combos is small, the main virtue of combos is crossprotection from resistance. Nevertheless, there could be a difference in residual stimulatory power, as you suspect. The data available are however way too limited for a firm conclusion.

Blank
Avatar_m_tn
testing if the mrdhelp site malfunctions
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Hepatitis B Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Hepatitis Answerers
Avatar_m_tn
Blank
stef2011
Italy
Avatar_m_tn
Blank
StephenCastlecrag
Australia
Avatar_m_tn
Blank
Rome70
Moscow, Russia
Avatar_m_tn
Blank
andrey19
Russia
Avatar_m_tn
Blank
mer971
Avatar_m_tn
Blank
makeadifferencenow