question about achieving svr if tx is stopped early

I'm geono 2 UND at week four. Taking pegasays. decided to shorten tx to 16 weeks, i remember Jim sent me some stats on a study of short tx in geno 2's. If i remember correctly people who are taking peg intron can stop at 12 weeks with a good chance of achieving svr but if you are taking pegasays you need to go to 16 weeks to have a better chance of svr. Did i get this wrong, or is there really that much difference in the medication. I take shot #14 on Monday if i get anymore problems with my blood or horrible pain, i don't know if i can make it. Does anyone know what the stats are on stopping at 14 full weeks vs 16. I know we never really know till our 6 month PCR but has anyone known people who have done this and it worked. I was also concerned because on my last cbc my hemoglobin dropped from 140 to 117. Someone mentioned this is strange to be happening now, considering it's been normal through tx. Could it be that the meds seem much stronger to me now because i have lost so much weight. Any help is appreciated. Thanks Anita

[aquarius64]

i dont know anything about the SVR percentages, but i'd like to know. i too was UND at week 4 and my labs have been declining since. i just did #12. my platelets dropped to 59 yesterday and my GI reduced my inf to 1/2 dose. don't know if this is normal, on the other board they said it was a bit conservative. my GI NP wanted to stop my tx but i said no, not after getting this far. i would at least like to make 16weeks. i hope things improve for you and you have SVR. have a nice weekend!

[snowbyrd]

Are you on pegasays or pegintron?

[jmjm530]

A couple of shorter course studies (16 weeks for Pegasys and 12 weeks for Peg Intron) suggested similar SVR rates for those who were non-detectible at week 4 (RVR). A larger study (Accelerate) concluded that the standard 24-weeks of treatment resulted in superior SVR rates -- 90 to 82 per cent approximately. I believe the shorter course studies used weight-based ribavirin while the Accelerate trial used a fixed 800mg dose. This may account for some of the difference in SVR rates in Accelerate.

But even using the "Accelerate" data, it appears that the shorter course is a viable option for those experiencing difficulty with treatment side effects, and personally I think it's a viable option for those with little or no liver damage who want to minimize their exposure to the treatment drugs, while acknowledging that they may be giving away "x" number of percentage points to SVR in the process, at least according to "Accelerate".

Anyone so motivated might google "Accelerate HCV genotype 2 and 3". Personally, if I were going to base a treatment decision on a study, I'd order up the entire study online as opposed to relying on abstracts. Then, I'd bring that study to my doctor for discussion.

Here is a link to the smaller "Mangia" study: http://www.natap.org/2007/HCV/021207_01.htm

You also might want to check some of the newer treatment presentations over at the Clinical Options site where they talk about individualizing treatment -- either extending or shortening based on viral response.

All the best,

-- Jim

[aquarius64]

pegasys 180mcg

[snowbyrd]

Me too, i also take 800mg of riba, it's suppose to be weight based but i now only weigh 100 pounds

[snowbyrd]

Thank you for the studies and info. I'm still a bit confused, i take 180mcg of pegasays and 800mg of riba based on my starting weight i have lost more than 10% of my body weight, if i was UND at week 4, what the heck is this tx doing to my body....what would be the the difference of stopping at the end of week 14 if my labs come back bad, why is my hemo dropping now.....is it just too much for my system to tolerate? I want to make it to week 16 but if my hemo drops i know this can take some time to rebound. it went from 140 to 117 between my last weeks labs. Could it be too much riba for my weight?
I will not allow myself to add any more meds to the mix...i just cant do it.

[traveler65]

You might want to talk to your doc about reducing your riba dose. I read somwhere that after getting halfway through treatment a reduction is not that detrimental to obtaining SVR. There was also a study that was posted here that showed in many cases 400 daily being just as effective as 800 daily. At your weight it could be OK. At least that way maybe you could continue with the peg through the 16 weeks. It's the riba that is making your hemo go down.
Good Luck