Aftermath of severe allergic reaction?

Question

It's official - I have to stop triple therapy completely because of my reaction to incivek. Lab test show my allergenically reactive cells at 17%; normal is 6%. I will start prednisone today at 60mg day, reducing to 10mg after 4 weeks. Who else has been through this?  I know prednisone is cleared through the liver (ugh) - has anyone had complications? My doc is willing to resume interferon/ribavirin at some point - who else has done that, pls? Since this was a study sponsored by Vertek,  I still don't know if my 10.5 weeks of trip therapy created a SVR. I will find that out after my week 12 blood tests, which are today. Thanks everyone!

nightbeacon · Answer

My doc told me the same thing yesterday - wouldn't that be great! Either way, I still feel very strongly there is a solution for me out there. I like being unique, just not necessarily in terms of treatment "failure".

nygirl7 · Answer

Yes we have. I hope it is true in your case too!  It sounds like you had the rash BAD!  :(

can-do-man · Answer

There is a chance that you are SVR, we have seen that here before with that many weeks............ Fingers crossed for you.

nightbeacon · Answer

it will be sometime after the prednisone treatment ends in 30 days - dependent I assume on what my bloodwork is telling them.  That's why I hate stopping - I'll likely lose any benefit gained over the last 3 months. But I've not got a choice at the moment. Doesn't do any good to be bummed though. I'll find a way!

nightbeacon · Answer

I'm lucky enough to have 3-4 docs at the University of Utah tracking me. They are not giving me a choice for anything but corticosteriod treatment because of this massive rash reaction - it covered 98% of my body at its worst and I still look like a leper 10 days after ceasing teleprevir.  As I understand their fears, the allergic reaction has become self-sustaining so that my body can't return to normal on its' own.  Left untreated, they would expect both liver and kidney damage, and in worst case scenario, death (!)

willbb · Answer

IN conclusion, despite clinical evidence that the use of steroids aggravates recurrence of HCV, our in vitro study suggests that there is no direct stimulatory effect of steroids on the replication of HCV. As such, the increased viral loads after high-dose steroid treatment are more likely due to a downregulation of the immune response. In such patients, a dampened immune response allows viruses like HCV to replicate free of immune-mediated killing of their host cells. When a change occurs, such as a tapering or an alteration of immunosuppressant drugs, the immune system reinitiates and vigorously attempts to control the virus, resulting in acceleration of liver damage. Therefore, either steroid avoidance or maintaining low levels, coupled with a slow tapering of corticosteroids, may be beneficial to HCV-infected transplantation recipient
 
http://www.ncbi.nlm.nih.gov/pubmed/17911459?ordinalpos=11&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

nygirl7 · Answer

What were your symptoms that lead to this anyway? Were they very bad?

nygirl7 · Answer

I'm on prednisone right now but I've been SVR about six years. I dont know that i would take it if I'd just gotten to UND unless I absolutely had to. I would ask him what he thinks about the immunosupressant part and is it worth the chance, is it really necessary?

can-do-man · Answer

"My doc is willing to resume interferon/ribavirin at some point - who else has done that, pls?"

I would ask him what he means by that, a few days or is he talking weeks. Also I believe the stats will gave above those people in either group did a total of 24 weeks without halting either the riba or interferon.

willbb · Answer

Hi..

I can't comment on the allegic reaction % numbers and the reasoning for discontinuing Incivek at 10.5 weeks
.It is never ideal to cease any of the medications early ,however in study data(below) the patients that did Incivek for only 8 weeks vs. 12 were only slightly less successful overall

In regards to taking the medication predisone.This is an "immune suppreseant theray "which may have an adverse reaction on your viral load being eradicated. Hopfully your doctor is very expeinced with this as it peratins to HCV and it's treatment.

best of luck...

Will

http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/ucm256328.htm

The T8/PR group, the overall SVR rate was 72%. The eRVR rate was 57% and the SVR rate for eRVR subjects was 87%. The SVR rate for no eRVR subjects was 52%. More subjects in the T8/PR group experienced virologic breakthrough after Week 12 while receiving peginterferon alfa and ribavirin alone, 16% compared to 10% in T12/PR group.