PegIntron vs. Pegasys

I know this has been a hotly debated topic before, but does anyone have any opinion on the difference in efficacy between the two manufacturers?  

I was placed on PegIntron last year when I was treatment naive and responded beautifully, but was discontinued due to hemolytic anemia.

This year, for no reason other than the doctor is used to Pegasys brand, I was placed on Pegasys.  The sx are a lot less, but so is the response.  Nurse practitioner (the person I mainly deal with) tells me it's due to interferon-resistance.  But I was only on PegIntron three months last year, and I've only been on Pegasys maybe five months now.

I keep finding articles that contradict, and I know that they're actually different molecules.  How can they be so interchangeable?

[jmjm530]

The general rule is that if you responded to one drug the first time, you will respond in kind in repeated treatment. To clarify, I'm not talking about an SVR but about viral response such as EVR.

In your case, this argues to re-treat with Peg Intron, if you had the reaction you and your doctors wanted. I don't know of any reason why you can't switch over now. If you doctor is not agreeable, get another opinion from someone who uses both drugs or Peg Intron.

BTW big is the difference in your response. Is the riba dose the same now and before? How about your weight, did it change?

[Bill1954]

The IDEAL study (sponsored by Shering -Plough) will be underway soon to directly compare Peg-intron/Rebetol to Pegasys/Copegus. For more info, here is the address ----

http://www.idealstudy.com/index.html

Until these results are released, I believe the jury is still out regarding efficacy.

Rev - If the info above is incorrect or skewed somehow, please step in and correct me.

Best,

Bill

[Wasabi Pea]

"The general rule is that if you responded to one drug the first time, you will respond in kind in repeated treatment."

You would think so.  That's why I questioned it so much.  I was told if I was really uncomfortable with it, I could switch over.  At my next appt a month later, I mentioned it again and the whole idea was shrugged off.

Last time on PegIntron, I went from over a million VL to less than 800 at the 12 week mark.  That's when they discontinued due to 7.9 Hb.  Weight dropped significantly from 185 to 159 maybe.  They dropped riba from 1200 to maybe 800.  No EPO.

This time on Pegasys, I started only at 370,000, and I dropped 2 logs to 3,700.  Not happy with that response.  Weight started around 176 and now at 159, though dropped less rapidly.  Just advised to increase EPO from 40,000 a week to 60,000 a week (7.6 Hb).  I'm only at 600 riba now.

Sx are different for me between the drugs.  Much more hair loss and flu-like symptoms with PegIntron.

I think I will bring up the possibility of switching to PegIntron.  At this point I have nothing to lose.  If they pull me off, I won't be thinking about tx again until October, which is enrollment time.  I'm thinking of switching to a PPO.

Do you think drug switching will make a difference?  The riba's the same.

[jmjm530]

I think switching drugs might help but in your case the overriding issue is your propensity to go anemic even with EPO. Everything else then becomes academic because once they decrease the riba beyound a point (and you seem to be at that point) your chances for SVR really decrease.

As I said in another post -- assuming your second round does not work out -- if it were me, and I wanted to treat a third time soon, I'd be looking  Viramidine trials. The drug replace ribavirin without the severe anemia.

[Bill1954]

Thanks so much for your response! I had heard some off-the-cuff remarks regarding the ethics involved in this study, but this is the first article I

[rifleman]

Sorry to hijack the thread, but I just found out my 4 week PCR came back undetectable. Yeehar. Also found out my yhemoglobin is hanging out at 12.8.  Pretty good kick in the ass for a Friday afternoon. In the spirit of the original question on this post, I would have to say Pegintron all the way!  Worked for me & will for you too.  100% compliance probably helps too.
DJL

[cuteus]

it seems like yesterday you  were asking questions about hep c, and today, YOU HAVE NO DETECTED HEP C!!! EVR is called!!!

[cuteus]

and/or RVR!! good for ya!

[scruffy]

Congrats-a four week undetectable is very very promising for SVR. frank

[Tallblonde]

Fabulous news!  Congratulations!

Susan

[friole]

EEEii ha -- get out your six shooters and celebrate.  That is the kind of news we like to hear.  I just did shot 2.

[Tonyz]

<font size="5" color="red">A heart Felt Congratulations</font>


                 Blessing TONYZ

[Califia]

Say, you think the chicken nuggets had anything to do with it?  Roaring great start, congrats!

[artgal]

Great news on the EVR -- there's nothing like hearing those words "you are undetectable"!! And it makes the treatment, if you are having sides, much easier to tolerate.
Please check Cbee's response to your earlier post of "how's everyone doing?" as she has some good info on length of tx.

[nyhepc]

glad to hear your good news. congrats!!!

[scruffy]

Hey TallB, been following your struggles and just want you to know my heart is always with you in spirit. frank

[Docsgold]

Congratulations!!  How wonderful to get such an early PCR.  I say treat yourself to a celebration.

[rifleman]

I considered a nice bottle of Newcastle Brown Ale, but decided it might be better to wait until later for that.  
Maybe the chocolate bars and chicken nuggets have strong anti-viral properties.
It is a lot easier to take the shots and pills knowing that they worked so well.  I'll bet the old liver is doing some serious regenerating.
DJL

[Bliss68]

That is great news...I found I have type 1a stage 2, started tx 4 days ago.. pagasys and riba. 180 units on the peg and 1200mg  twice a day on the riba. 3 pills twice a day..  Got a little sick the first day, several hours. Now havent felt sick at all.. going to work in 1 hr.. I told a few people at work about this..the HVC, dont know if you remember when we discussed this? but HPD hasnt tried to retire me yet....also started to do the Lauers Duracoat.. purchased two springfield mil spec.45's going to do one olive green and one desert tan..and gong to put them up for sale in a gun shop never fired and see if I can get gun finishing started like we talked about. in case I do get the heave ho.. If you can send your email would like to email you some pics of a few I have done..Rifleman I hope the best for you, and want to thank you for yout positive outlook, it has helped me in ways i cannot describe.  I have found I do not even think about the negative parts of this HVC stuff anymore (for the most part). Keep in touch  Bliss  ps...is not getting sick a good sign?

[friole]

Interesting hobby, guys - one that I have been sort of thrown into.  I am a gal, but have become pretty informed lately on military and other gun history.  Dad died leaving all his "collection" to us kids.  My brother and I have been selling slowly on GB and AA and, thru this experience, I am learning a lot of history.  It is actually quite fastinating and the people I have met, have all been great.  Until I joined this forum, the only other forums I have been active in are the various gunboards.  Between selling on GB and researching guns and now researching hep c, I have way too much computer time.  It is fun, though.

[rifleman]

Well, you are on the Pegasys, it doesn't make you as sick as fast as pegintron, or so I hear.  Yesterday I drank a giant Dairy Queen hot fudge/chocolate shake and boy, didn't I pay.
My first shot hit me like a rhino, but I'm thinking that I eliminated a lot of viruses that weekend.
I've also found that your hobbies can take a bit of a backseat at first.  Fatigue and malaise during the weekends are common.  However, I started messing around with my firearms again.  Bought a synthetic stock for my Mossberg 500 and am getting ready for deer season.
DJL

[rifleman]

Uhhh....part of that "collection" that hasn't been auctioned off yet wouldn't happen to include a Springfield M1A1 (semi auto only version of the M14 battle rifle) or a 1941 Johnson rifle, would it???
DJL

[friole]

By the time everyone in the family took what they wanted (I have 3 brothers), all the M1A1's were spoken for ( think one of my brothers took 2 or 3).  Didn't get to sell a one. Had a 1941 Johnson and the same - brother put it on his list. Boy are those things hot!  Did sell a cool Winchester trenchgun. If you do a smart search on GB you can click on seller's name and put in "gunsfromdad".  You can see our current and past 90 day auctions.