Aa
merryBe
Please check out the slide set by Dr. Mitchell Shiffman released today at Clinical Care Options.
clinicaloptions.com
clinicaloptions.com
Yikes. Brain not functioning at this hour. I'll try that sentence one more time:
"In any event, the only studies I'm aware of for extending tx are for slow responders, i.e. those with >2 log drop at week 12 (but still detectible) and then becoming UND at week 24. In other words, that means you need at least a two-log drop by week 12 to continue on.
"In any event, the only studies I'm aware of for extending tx are for slow responders, i.e. those with >2 log drop at week 12 (but still detectible) and then becoming UND at week 24. In other words, that means you need at least a two-log drop by week 12 to continue on.
Third paragraph should have read in part:
"In any event, the only studies I'm aware of for extending tx are for slow responders, i.e. those with >2 logs at week 12 but UND at week 24. That means you need at least a two-log drop by week 12 to continue on.
"In any event, the only studies I'm aware of for extending tx are for slow responders, i.e. those with >2 logs at week 12 but UND at week 24. That means you need at least a two-log drop by week 12 to continue on.
Wondeful news about your son. If I remember correctly, both his viral load tests were UND so I would be very optimistic at this point.
As to your extension, I do question the article Schwartz mentioned, that you seem to be basing your decision on, at least partly.
Have you seen it? I couldn't find it in this month's "Gastroenterology". In any event, the only studies I'm aware of for extending tx are for slow responders, i.e. those with <2 logs at week 12 but UND at week 24.
Unless you have a significant decline at week 12, you would be considered a null responder (I believe you currently have <1 log drop at week 10?) which means extended tx doesn't offer any benefits according to the studies I've read. Anyway, always good to get hold of, and read the full-text of any study you're making a treatment descision on.
I did see your thread, but the link took me to a study for treatment naive HCV/HIV co-infected patients. Maybe you're referring to a different article?
Be well,
-- Jim
As to your extension, I do question the article Schwartz mentioned, that you seem to be basing your decision on, at least partly.
Have you seen it? I couldn't find it in this month's "Gastroenterology". In any event, the only studies I'm aware of for extending tx are for slow responders, i.e. those with <2 logs at week 12 but UND at week 24.
Unless you have a significant decline at week 12, you would be considered a null responder (I believe you currently have <1 log drop at week 10?) which means extended tx doesn't offer any benefits according to the studies I've read. Anyway, always good to get hold of, and read the full-text of any study you're making a treatment descision on.
I did see your thread, but the link took me to a study for treatment naive HCV/HIV co-infected patients. Maybe you're referring to a different article?
Be well,
-- Jim
thanks for the bump, didn't see your response. Yes, I got the OK to go ahead for 6 months, but am still angry they gave me the no heads up at 4 weeks, only at 8...by which time it was not even possible to reason with them....sheesh
the excuses were lame...we didn't tell you so you wouldn't lose hope....we assume the insurance won't pay....we forgot you said you could pay....etc. why say "you are fine" say what you mean people!!
I figure at this point I've got nothing to loose by going a couple more weeks just to see if now that the bad infection is about gone my body will begin to fight the HCV virus instead again...
If I continue then to hover, or make no downward progress, then OK, rest and regroup it is.
However, I think it was telling them what Shwartz said, about the 6 month UND's that went out 72 weeks having a 20% better shot that may have at least got me a reprieve if not heavier dosing.
At this point, almost side effect free, what's one more month if things might heat back up.
Otherwise I'll be in line for the PI, and you are right, weighing in the kidney failures, etc with all the other stuff I already have....the study is just too small for me to run off to sweden for.
though shipping my blood before the riba ends will still be an option.
and, I can wean myself off INF, and pretreat with Riba next go around...like we should all be doing, so that's my back up plan.
Son came back negative on the TMA, thanks for asking. So we have 2 pos. 2 negs, now.
which means, basically we test again in a couple months and hope for the best and meanwhile live in limboland not knowing what else to do with so many opposing results.
Did you see my thread on Europe cutting off retreaters options?
the excuses were lame...we didn't tell you so you wouldn't lose hope....we assume the insurance won't pay....we forgot you said you could pay....etc. why say "you are fine" say what you mean people!!
I figure at this point I've got nothing to loose by going a couple more weeks just to see if now that the bad infection is about gone my body will begin to fight the HCV virus instead again...
If I continue then to hover, or make no downward progress, then OK, rest and regroup it is.
However, I think it was telling them what Shwartz said, about the 6 month UND's that went out 72 weeks having a 20% better shot that may have at least got me a reprieve if not heavier dosing.
At this point, almost side effect free, what's one more month if things might heat back up.
Otherwise I'll be in line for the PI, and you are right, weighing in the kidney failures, etc with all the other stuff I already have....the study is just too small for me to run off to sweden for.
though shipping my blood before the riba ends will still be an option.
and, I can wean myself off INF, and pretreat with Riba next go around...like we should all be doing, so that's my back up plan.
Son came back negative on the TMA, thanks for asking. So we have 2 pos. 2 negs, now.
which means, basically we test again in a couple months and hope for the best and meanwhile live in limboland not knowing what else to do with so many opposing results.
Did you see my thread on Europe cutting off retreaters options?
Not sure if you've seen my response to you in this thread which has floated down a bit:
http://www.medhelp.org/posts/show/359691
No need to respond, just wanted you to see it as it relates to this discussion.
---------------------------------------
Any movement on getting your son another viral load test? I don't know what they use in-house, but those two tests I mentioned are pretty good, and maybe you can just have his PCP order them up, if the liver center gives you a hard time. No rush, as I believe he tested UND recently? But follow-up seems in order, since a level of uncertainty seems to exist.
http://www.medhelp.org/posts/show/359691
No need to respond, just wanted you to see it as it relates to this discussion.
---------------------------------------
Any movement on getting your son another viral load test? I don't know what they use in-house, but those two tests I mentioned are pretty good, and maybe you can just have his PCP order them up, if the liver center gives you a hard time. No rush, as I believe he tested UND recently? But follow-up seems in order, since a level of uncertainty seems to exist.
I think you have to take the study for what it is -- and yes, there were only ten participants (total) and only one drop out. You can find the details you want by ordering up a full-text version if so motivated. I have it on one of my hard disks but not able to supply a link.
As to Telaprevir, again, it is what it is. So far, it appears 60% SVR in 24 weeks, and that's without helper drugs. That's a better rate than SOC in less than half the treatment time which means half the exposure to the drugs, the biggie IMO being less exposure to interferon.
Telaprevir, certainly isn't the end all, just one example of perhaps a better alternative now, to for example very high dose ribavirin, for reasons previously cited.
Did you finally take your week 12 test? Any resuts? Last I remember you sitll had less than a one log drop at week 10. The time for higher dose (riba or otherwise) intervetion IMO would have been back around week 4, when you still had less than a one-log drop. At this point, especially if you don't have a dramatic drop at week 12, I think you seriously have to listen to your doctors and stop. Rest up. And then fight another day, with whatever appears to be the best approach at that time. And given you were given no heads-up at week 4 with such a weak response -- in fact, weren't you told things were "OK"? -- I think treating with a new set of doctors next time would be a reasonable decision.
-- Jim
As to Telaprevir, again, it is what it is. So far, it appears 60% SVR in 24 weeks, and that's without helper drugs. That's a better rate than SOC in less than half the treatment time which means half the exposure to the drugs, the biggie IMO being less exposure to interferon.
Telaprevir, certainly isn't the end all, just one example of perhaps a better alternative now, to for example very high dose ribavirin, for reasons previously cited.
Did you finally take your week 12 test? Any resuts? Last I remember you sitll had less than a one log drop at week 10. The time for higher dose (riba or otherwise) intervetion IMO would have been back around week 4, when you still had less than a one-log drop. At this point, especially if you don't have a dramatic drop at week 12, I think you seriously have to listen to your doctors and stop. Rest up. And then fight another day, with whatever appears to be the best approach at that time. And given you were given no heads-up at week 4 with such a weak response -- in fact, weren't you told things were "OK"? -- I think treating with a new set of doctors next time would be a reasonable decision.
-- Jim
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
