LOW PLATLET COUNT

[JUDYW]

IF THE BEST TREATMENT FOR HEP C IS THE USE OF INTERFERON, AND THAT TREATMENT IS NOT RECOMENDED FOR PEOPLE WITH A LOW PLATELET COUNT.  WHAT CAN BE DONE TO RAISE THE COUNT SO THE TREATMENT CAN BE USED?  OR IS THERE AN ALTERNATE TREATMENT THAT CAN BE USED EVEN WHEN PLATELET COUNTS ARE LOW?

[cheriums]

I've got my lab values here to show that for me, at least, the Vioxx has been helpul.  I believe.  No! Celebrex is not the same.  I have OA, and was taking Celebrex (200 mg twice/day) when I started treatment (Pegasys + RBVN) in January. My platelets, always normal before, dropped like a stone in a well during the first 4 weeks of treatment, to half what they had been usually.  I switched from Celebrex to Vioxx, and only lost a few (less than 10) more platelets during the next 4 weeks.  Then, my count came UP in the next 4 weeks. It went down some again by the time I had the mext monthly blood draw.  But, the overall result is that I have not had enough of a drop to need to reduce my Peg. dose.  Which I would have, if the count had kept dropping the way it did for me in the beginning. Of course, I have no way to know for sure my platelet count would not have done the same without the Vioxx.  But if one needs medication for muscle aches, joint pains and the like, it seems worth chosing Vioxx if your platelets look shakey.

[TnHepGuy_]

I sure would be interested in finding out if your doc thinks that this particular pilot study on Vioxx is flawed in any way. And what his overall concerns with Van Thiel's work might be. Any shot at pumping him for some info on the subject, you think?


TnHepGuy

[gonagetbetr]

I would think that cold hard facts are just that
I wonder if your doc has a personal issue with him
Who knows I guess like everything else there are the good and there are the bad
I have seen some real dr horror stories here and also seen some docs that seem to genuinely care and are informed to the 9s

Personally I think that some that are on the forum need to go to medical school once they are done with tx and become hepitoligists so that they can treat the rest of us.

Any takers for med school????
Ill even make a contribution to your education :0)

[raheem]

I finished 48 weeks of tx about a month ago and my platelets were always within the normal range.  However, I did email my Dr. the Vioxx pilot study and he responded that his GI group actually knew David Van Thiel and therefore had questions regarding the results.  We didn't get into it but he said he had seen other studies by Van Thiel and was not very impressed with his work for whatever reason.  This doesn't mean Vioxx is or is not beneficial, but rather my Dr. needed more information and corroborating studies before signing on to this particular treatment regimen.

[TnHepGuy_]

The biggest concerns I've always read about for those taking Vioxx are heart-related ones (and, from an article I saw not too long ago in the Wall Street Journal - they occur in approximately 1% of patients). I was thinking that if doctors are concerned about giving it to patients because of the risk - I wonder if using Celebrex instead might also benifit combo tx patietn's platelets - without the potential heart issues? I have seen no studies to say that Celebrex would help with platelets, but it is in the same class of drugs as Vioxx. Another possible option, perhaps?


TnHepGuy

[woodbeegood]

i aslo took that vioxx study to my dr-he agreed to let me try it-after 2 wks my platelets went from 63 to 81-don't know if it was a coincidence or the vioxx-next bloodtests are next week-we will see-do know that since starting the vioxx i don't have to take the tylenol or advil for muscle aches as much as i was-so there is a real plus there

[glamazon]

I was diagnosed with Primary Thrombocytopenia years before I started Tx, largely due to my HIV co-infection. My immune system is actually attacking my own platelets as foreign invaders! Bummer, huh?

With this history my doctor ordered frequent labs and adjusted my meds accordingly. After the first month of Tx he titrated my dose to 90 mcg of Interferon and only three daily Riba pills. After 24 weeks he had me discontinue the Riba but I maintained the 90 mcg dose until the final two months when I went back up to the full 180.

My doctor watched my CBCs closely, sometimes once a week, and platelets never dropped below 25 so he kept me on Tx. The moral of the story is that careful monitoring by a knowledgable physician can make Tx possible in some cases where it might seem contraindicated.

Christine

P.S. My AST/ALT levels dropped to the normal range after two months of Tx, and my viral load was undetectable after three months.

[lost and confussed]

Judy,
I have printed my copy and will meet with my doc on monday, My platelets are low going in also but this is a question I had myself.
there is a ton of info in lower posts regarding vioxx.
I will let you know what my doc says after we talk
good luck to you

[TnHepGuy_]

There is a small <a href="http://www.natap.org/2003/AASLD/day7_1.htm">pilot study</a> involving Hep C patients on combo therapy who received Vioxx to help control the drop in their platelet counts. The major concern with Vioxx is with patients who may have any kind of heart condition - though the dosage used in the study (12.5 mg.)is lower than the normal dosage prescribed. As Nann found out - most doctors have no idea about this study. So if you are interested, print off a copy, bring it to your doctor and discuss if you might be a candidate for trying it.


TnHepGuy


(URL for above study):

http://www.natap.org/2003/AASLD/day7_1.htm

[Nann]

I just saw your comment below.  I don't know of Dr. Yoshida but have met others like you describe him.  Anyway, referring to what I mentioned to JudyW--the hematologist/oncologist I went to last month at first laughed at what I told him about the study on Vioxx.  He said Vioxx is what the docs avoid when you have low platelets and started describing how it causes platelet problems.  But when I went to the follow up visit, I had the report that I had seen on this forum with me and showed it to him and he spent a long time reading it completely.  Then he said, well, usually we like many studies on something like this, but these results are impressive. Then he asked if he could have that copy. So, I am waiting to ask my liver doc about this too.  But, it is so strange that these doctors are not up on studies like that. So we'll see.

[derail]

sorry for jumping in on an unrelated rant,this only reinforces what I have previously stated ,couch, as to how important it is to rattle the sabres during this election in June. Write letters to the editor posing questions to the Liberals and ask them when are they going to do something.If more profile can be raised we may have hope,yet .  Good luck and I hope you can get some resolve to this. Daryl

[Nann]

Hi,
     You don't say what your platelet count is but mine are 30.
They have been in the 20's for 8 months.  I have been on peg for two years. I went on my own to a well known hematologist from UCLA and he said not to worry.  When I started peg my platelets were in the 80's. As far as I know, there is no treatment to raise platelets.  Supposedly they go up after you stop treatment. I would talk to your doctor about it. Good luck.