Neupogen

[deputydog]

I am an hcv patient with genotype 1a virus.  When I started treatment my viral load was 4.5 million.  After 9 mos of Pegasys and ribavarin treatment, my count is 13300.  Friday's blood test revealed a wbc count of 1.4 and dr. wants me to begin Neupogen injectable 1x day until, I guess my wbc count increases.  Has anyone tried this and what is your experience, and are there other alternatives to raising wbc?  Off the subject, my heart "feels" weak.  I have mitral-valve prolapse and am concerned that all these meds can't be good for that.  Any help would be so appreciated...

[hrsepwrguy]

"body and bones ache"

In all phase 2 and 3 trials‚ medullary bone pain‚ reported in 24% of patients‚ was the only consistently observed adverse reaction attributed to Neupogen® therapy. This bone pain was generally reported to be of mild-to-moderate severity‚ and could be controlled in most patients with non-narcotic analgesics; infrequently‚ bone pain was severe enough to require narcotic analgesics. Bone pain was reported more frequently in patients treated with higher doses (20 to 100 mcg/kg/day)

http://www.drugs.com/pro/neupogen.html

[thegift]

Had kidney transplant five months ago now wbc went down to1 and now just completed three day of neupogen shots   body and bones ache and now have fever of 99.1 anyone experience this?

[BobK]

I've only done treatment once and that was the 100 week march....trail of tears or at least what hair I had left!  I did have a lot of negative factors that led to the development of the 100 week regime.

I will post a synopsis of what I have found and learned about antioxidant and antifibrotics in the near future ( and where I got the info of course).  I have been asked to do this for another list and I feel that resistance is futile so I will comply!  It might take several days before you see the reply since I am busy in the lab with some experiments and a minor budget crisis on a salmon project I will be working on!

take care all,
BobK

[OkieJim]

Just did my first shot of neupogen 1 hour ago. Anyone know how long it takes for the sides to kick in? If not I guess I'll find out soon. My neupophills(sp) have dropped to .68 on my last CBC results. After shot #4. This is why DR has me on neupogen.

[TravisB]

I have heard of doctors that treat longer than a year.  One protocol is to treat for one year after the patient first tests clear.  At this point there is very little proof that it is beneficial to many people.  Not enough studies have been done to really say. How are you handling TX at this point?

[willing]

Hi Bob - good to hear from you again. I've thinking about your bx (and your long march...) best wishes on the results. It seemed that you'd done a lot of research on anti-fibrotics including liver antioxidants and IFN maintenance therapy. There's been interest in that topic from quite a few people lately. If you feel like posting a summary I'm sure it would be of general interest.

[Revenire]

Hey Bob,

Good to hear from you too!! How many times have you done treatment? It sounds like you've been through the wringer ...

Take care,

Scott

[TravelGrl]

In my experience, a neupogen shot raises your wbc immediately...One shot, once or twice a week should be all you will need.  A wbc of 1.4 after one shot on Neupogen will probably go all the way up in the normal range...It will slowly come down again, therefore needing it maybe twice a week..Have your doctor monitor you closely the first few weeks of using it.  But daily to me sounds like way too much.  

I agree with the other posts, you should have a talk with your doctor about raising your dosage, if you are able to clear than extening your treatment 9 months after that....The way you are going now, you probably won't clear and if you do, you probably will relapse...So raiseing the doseage and extend treatment may be the way to go....

Good Luck
Jodi

[BobK]

The decision to treat while still testing positive might be due the extent of liver damage in the individual.  If a person is up against the wall and facing a progression of cirrhosis a doc would be wise to treat with INF for its ability to slow or halt the rate of fibrosis progression....in the majority of cases!

regards,
BobK

[BobK]

That would be bear bile not buffalo juice   ;-)

Just got skewered the other day so I'll know more about the condition of my liver in another week.

Liver panels are still normalized, for whatever that is worth....that is after taking the bear bile (ursodeoxycholic acid) and high doses of vit E.

thanks for asking though,
BobK

[jamit_a]

HI,
just a heads up on (SVR) sustained response! You should be undetectable by now!
Recent studies with Pegasys(Pegylated Interferon - alfa 2a) plus Rebetol combo therapy show overall sustained response rates climbing to as high as 61% for all genotypes combined.
If you are responding well to treatment your PCR viral load should drop by 90% per month.
If your PCR viral load does not drop below 450,000 copies/ml after the first month of treatment, there is a high probability that you will not have a sustained response.
If your PCR viral load is still detectable at the end of six months of treatment, there is a high probability that you will not have a sustained response.
If you have genotype 1, you should be treated for a minimum of 48 weeks.
If you have any of the other genotypes, you should be treated for a minimum of 24 weeks.
Patients willing and able to undergo treatment for longer periods of time have a greater chance of a sustained response or even a cure.
Talk to your GI, you may need to stop therapy at this point.
In any case take care and feel better!
God bless,
jamit_a

[Revenire]

I take Neupogen once every 3 weeks. My WBC rebounded so high the doctor said there was no need to take it weekly, for me. The side effects of it were tough on me: felt like a truck ran over me. Maybe it was the combination of the interferon and ribavarin that caused that?

[kennedge]

hey
it's been a while since you've checked in..hows the buffalo juice working?

[reposyco]

I WAS AT THE HEP DOC TODAY AND I MET A GENTLEMAN THE DOC ORDERED 72 WEEKS AND AT 50 WEEKS STILL NOT CLEAR,IS THIS A NEW CONCEPT TO TREAT LONGER??

[TravisB]

You didn't ask for any advice on this issue but I want to weigh in on the side of Scruffy and kennedge.  If past studies are any indication you are now where you should have been after about 10 weeks of TX viral load wise.  Given the fact that you have some other health issues, you might consider talking to your doctor about how and if to proceed with TX.  Whatever you decide, I wish you the best. Travis

[AK - Hepper]

Unfortunately, it doesn't look very promising according to all the studies. Don't you need to be undetectable at 24 weeks to have any realistic chance of svr? I know you hate to stop, but it might be time to consider throwing in the towel, look for some kind of alternate course, maybe higher dose peg or something. Sure sucks being a 1er...

[scruffy]

I would have to agree with kennedge.I wish you well whatever course you choose.

[kennedge]

well the really big question is why and for how long does your dr want to keep you on treatment...at 9 months you should have undetectable VL (viral load) sorry to to say but you are classified as a slow or non responder and need to have a serious discussion with your dr in regards to your treatment

or maybe a second opinion

any help out there gang?

[Galen]

I just completed tx a week and a half ago and was on Neupogen from week 9 on.  There can be muscle and bone achiness and sometimes a slight fever, but there are no known long term side effects that I have been able to find.  WBCs are obviously important in fighting infection and for you that includes the types of infection that can affect the heart such as endocarditis (This can happen as the result of having dental work done without being on antibiotics.  I had rheumatic fever as a child and consequently contracted endocarditis after a dental cleaning at 21 and spent 2 weeks in the hospital, 5 of those in intensive care.  [Infective endocarditis is defined as an infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium, or a septal defect])  Not to say this will happen to you, of course, but you do need to be very careful to avoid infections and make sure your dentist knows about your condition.  I decided, on the reccommendation of my GI and dentist to forgo dental work on tx because of my pre-existing condition.