twice weekly higher dosing

My friend just sent me a conference report from the May 2004 hepc conference in New Orleans.  It states there is superior efficacy of twice a wekk administration of peninterferon alfa-28 plus ribavarin. in obtaining SVR in HCV genotype 1.  The dosage was a twice a week mean dose 2.5 ug/kg/week.   Does anyone have anymore information on this?  I have an appt. with him Monday at 4.  I am just starting week 9 and if this is significant it's my hope he would have known about it.

[bobbyullc]

i read two italian research papers showing drastic improvement in svr for twice a week dosing. like 58% - 27%. i hate to admit it but for the last 4 weeks i have on my own been doing just that. i get a vile with 178mg total(120/.5 mg) and take 0.5 on sunday and 0.2 on wed. i remove the top of the vial and split the dose manually.
this has also reduced the side affects like the papers show.the sides have been the best in 11 weeks of treatment.
my 12 week pcr is dec 6th and i will keep in touch.

i am NOT recommending this for anyone else just fyi.

http://www.hivandhepatitis.com/2004icr/ddw2004/docs/0516/051604_hcv_h.html
http://www.natap.org/2004/DDW/ddw_04.htm

[cougareyes]

If you are talking about peg-intron I have read their molecule doesn't stay in your system to the same level of dosage as pegasys over the course of the week. Yet SVR rates are about the same with both drugs. The standard dosage is once a week, if you can handle a 2x a week dosage and are going to make a proposition to your doctor. I would take a copy of that report and anything else you can find to back your case.
I believe if you are going to tx, blow the little suckers out of the water once and for all. At week 9 you might find yourself already undetectable. This double dosing I believe may be more effective in the beginning of tx, to get to undetectable as fast as possible.
It wouldn't be standard dosing for 1st time tx, but when you think about it; if you can handle the interferon: it would be a good idea.    Peace

[bobbyullc]

please let us know what your doctor has to say.
bobby

[cougareyes]

We crossed post, interesting you say the sides are better. I wonder if the interferon counteracts the sides of the riba.
Peace

[bobbyullc]

the artical claims that the body gets used to the peg and that reduces the sides of the peg. i have not gotten sick from my shot since i started this. i am going to fla. thur. for a week just because my sides are low. at day 6-7 the peg is undetectable so the improved svr.with two shots.
AGAIN. PLEASE UNDERSTAND I AM NOT RECOMMENDING THIS FOR ANYONE.
lol bobby

[new-sojourn]

I did 3 0.2ml shots a wk of Interferon Alfa-2b Recombiant (pen).  plus 5 200mg ribavirin capsules a day.

So that was 72 shots over a 24wk period.  I was a 2b and cl'd by day 18.

I always wondered why I did 3 shots when everyone else did 1 shot a wk. This is my 4th holiday season since cl'ing.  I was infected in 1967 via transfusion and wasn't dx 'til after my liver failed.

[bobbyullc]

you did the old interferon that only lasted 48hrs. the peg/interferon is supposed to last 7 days.

[new-sojourn]

I really don't give a sh** what I took b/c I was cured before I even had time to ***** and then there was no reason to ***** b/c I waS CURED.

[dutch_boy]

Thanks for your quick reply and all the pertinent information.  Can you summarize what your experience has been on the daily Infergen?  I know if your energy is anything like mine you may not want to write too much so feel free to summarize!  What led you to the option of daily infergen.....I remember some time ago that you were on standard Interferon and you didn't get the results you needed to continue? Or did you relapse after tx? I remember you have been through alot but don't remember the details.  Thanks for filling me in.  I want to be able to suggest to my friend what to do next as he seems so defeated right now. I'm trying to be optimistic but it is hard when this virus treats us all so differently and throws us these difficult challenges.
Thanks Susan for your response.  I am wishing you well. Scott

[oneday]

Is your post really necessary.  You sound very angry.  I am choosing to believe that my attitute is going to get me through this.......my doc is amazed at all I continue to do because I believe I can.   Best of luck to everyone and I want to read more positive thoughts....

[cuteus]

What wk are you now on?
GL on that PCR! I hope it reads negative!

I wanted to ask you again about the epidurals. did you have the set of three shots? Did it help a little, a lot or not at all? Mine lasted 5 wks, but I only had one shot. I can't afford to take time off, need the money, so I was thinking about trying the 3 shot series and see if the benefit lasts more than 5 wks.

Good LUCK again!
I want to read undetectable next to your name for once!

[susan400]

Cuteus,

I did have the 3 shots about 10 mon. ago.  I don't want to discourage you, but that did not work for me.  However, I have a friend who is getting them and she had no problems and they've helped her.  I just ended up with get the surgery.  I still have some residual back pain even with that, but nothing like it was before.  The doctor says that the residual back pain could be there still, when he was explaining the surgery to me.  I think that the 3 epid. shots are supposed to last for 9 mon., if they are done correctly and it gets to the right spot.  On 2 of my shots, the pain control Dr. screwed up.  She even came in to the recovery area and admitted as such and showed me pictures.  She hit a ligament, which obviously did not help me any with my pain.  I wasn't real impressed with the care that I got from her and don't believe that I'll go back to her again.  

Thanks for your encouraging words about my viral load.  I'd love to be clear, at least once in my life!

God Bless, Libby

[dutch_boy]

I too want to see you post someday "undetectable"!  You have been through so much.
My dearest freind just got his PCR back only to learn he initially at week 4 responded beautifully but his 12 week PCR showed no further reduction of virus since week 4 and is now contemplating what his options are. He did not achieve a 2-log drop. I understand you are presently taking 8 ribas a day.  How are you doing?  I know these ribas cause me the worst sides!  What interferon are you on at what dosage?  Are you on Infergen every day or on Pegysus or PegIntron weekly?  If you have time fill me in as I am hoping to suggest some alternative ideas to standard tx to my freind who is so lost for hope.

I am week 44 out of 48....see the end in sight but my body is beaten up I'm afraid...hemoglobin has been stuck at 7.3 for over 7 months of tx.  We will hopfully all some day have this behind us and you deserve those special words of "undetectable"!  I'm wishing you the best Susan.
Scott

[susan400]

Scott,

Thanks to you, too.  I am on daily Infergen at 15mcg daily, the 8 Riba's, and Procrit.  I did have a 2 log drop (just shy of it but the PCR was early and the doctor is calling it 2 log), for my 1st 3mon.  

Susan

[susan400]

There's also a study about taking higher doses of Riba, which I'm doing right now.  I've already tried double dosing of Interferon without success.  I did have a big drop in viral load at that time, but did not clear.  Currently, I'm on 8 Riba's a day.  I should be getting another viral load done in a few weeks.

Susan

[susan400]

A quick summary. Started with Reg. Intron-A 3xa week and 1000 Riba daily back in 1996-1997.  Non-responder or partial(with the LFT's).  After a break, doctor tried me on Infergen high dose induction. Back then, the protocol was daily for 30 days and then, switched to 3 times a week. Also took Riba.  Another break. The doctor had me go on maintenance dose of 1mu of
Intron-A 3 times a week and 1 Riba daily for several months.  My LFT's started to go up on the maintenance dose, so the Dr. said there was no point in continuing.  Another break.  They came out with Peg-Intron.  So, I did that for 48 wks. + Riba. Did not clear.  Another break.  Then, Dr. tried me on Pegasys, (Zadaxin) Thymosin and Riba.  My LFT's and viral load went up, Dr. stopped me again.  Another break.  Next I was on Peg-Intron twice a week, plus daily Intron-A and Riba.  I had the best response ever to this regimen. I did it for 15 mon.  I should have continued longer because I almost got a clearance.  But, I was so anemic and feeling so crappy that I stopped, my choice.  Another break.  Then, I was on daily Infergen of 9 mcg (slightly greater than a 1/2 dose) + Gamma Interferon and Riba. For 8 mon. I did this.  But, I got a herniated disk and needed surgery, so I had to come off of treatment and prepare for that.  Another 5 mon. break, had my surgery and recuperated. Then, in July of this year, I started on the Procrit, daily Infergen 15 and high dose of Riba. That's what I'm on now. Susan

[dutch_boy]

You are the strongest, most resiliant person......not to mention brave!  I am blown away by your story and struggle of your fight.  When the chips are down for so many of us we all need to hear your story to get the strength and encouragement to carry on!  MY wish to you Susan is that this be your last....very last....time to put yourself through this.  This time will work for you!  With such a great spirit and attitude it has no choice but to work!  Thank you for sharing your story.  I'm sure others will find great hope in your story as well.
Bravo to you and I'll be anxious to hear about your progress.
Scott

[jmjm530]

Curious on how much you weigh to see if your doc put your on the high end of a weight based riba formula or is just dosing high. Also, how has your hgb behaved with all the riba and are you on Procrit and if so how much.

-- Jim