Researcher Please

What are the true ramifications of dose reduction and SVR.  There are so many of us that have had our meds adjusted due to "Anemia".  Do we still have a shot at SVR?  

[jmjm530]

I'm not *the* researcher, but I occasionally do a little research :)

No specific answer to your question because there are so many variables, including how much of a dose reduction you had, what meds were reduced, what week they were reduced, what has been your viral response, what has been your hemoglobin response -- not to mention your pre-tx predictors such as genotype, fatty liver, cirrhosis or not, etc, etc.

But in general, the fewer dose reductions the better. Better to use a helper drug, for example, such as Procrit than to reduce the riba, medical history permitting. Better to use Neupogen, if required, than to reduce the Peg. In fact, I've read that if you miss two consecutive Peg injections you might as well start over -- although don't know how scientic this is, and an interim viral load test I would imagine would settle that issue.

There is also something called the 80-80-80 rule, which states that if you take 80 per cent of your Peg and 80 per cent of your riba, 80 per cent of the time, then you are OK. That said, this rule was derived out of specific studies and does not mean that you won't lessen your chances of SVR even if you stay within the limits. Non-compliance is one the biggest factors in relapse and most docs tout the importance of full-compliance, not a percentage of compliance.

Sounds like you may have had your dose of ribavirin reduced? The good news is that some more recent studies suggest that reducing ribavirin after UND may not make much difference, although I'm not sure if that was a geno 1 study -- might have been a geno 2 and 3 study.

If you want to share your stats, including your riba reduction, when it happend, and what was your hemoglobin pre-treatment and at time of reduction, etc -- maybe someone can give a more specific answer, but not a definitive one.

-- Jim

[Libzo]

Thanks for your thoughtful response.  I was looking for a general study observation - How many that couldn't take rescue drugs, had to have dose reduced, but still managed to get through TX and attain SVR and whether there was a higher relapse rate for those that did manage UND during treatment.  I was asking because of the frequency of dose reduction.  Thanx.