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Impact of Growth factors (procrit, neupogen) vs Dose Reduction in HCV treatment

I'd like to generate this dicussion here.  

While this article relates to HCV treatment for HCV/HIV co-infected, I found the SVR outcomes very interesting for those in HCV treatment who used growth factors for anemia caused by low hemoglobin (HGB) and for neutropenia caused by a low absolute neutrophil count (ANC).  

The first chart shows that use of growth factors improves SVR rates over dosage reductions, particularly in the case of interferon.   What is NOT clear here is when the dosage reductions were applied over the course of treatment (first 12 - 20 weeks or later?) and by how much (more or less than 80% adherence?).    

The later chart compares the impact of using growth factors vs dosage reduction on increasing HGB and ANC levels and both appear equally effective only when talking about improving blood count levels and not in relation to SVR.

However, the comparison of these two show that using dosage reduction instead of growth factors can be at the expense of SVR.  

http://www.natap.org/2006/DDW/DDW_28.htm

My perspective increasingly favours use of growth factors as a way to proactively or reactively address low blood count levels to avoid dosage reductions wherever possible to improve adherence to HCV drug therapy, adherence being consistently cited as one of the greatest factors for success.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Adherence.pdf

I have had a hard time coming up with enough concrete data on this and would be interested in any contributions or discussion here that would illuminate on this subject.

Thank you.

Trish
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Avatar universal
thanks for that enlightening information. will keep that in mind when i start tx soon.
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Avatar universal
Thanks for posting the link.  That link, however, deals with human growth hormones and it's obvious I should clarify.  I apologize for being obscure, I tried to be clear and it didn't work very well.

Sometimes epogen/procrit and neupogen are referred to as growth factors, I suppose because they factor in the growth of the destroyed components of red and white blood cells.  When I say growth factors, I'm referring to rescue drugs like epogen and neupogen.

Trish
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Avatar universal
Oh, I I get it.  I just associated growth factor with growth hormone.  I didn't look at the link.  My bad - makes perfect sense now.
Trin
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372366 tn?1284403873
There are also many new studies that cite a 1aer can stop treatment at 24 weeks if they cleared it at every test. Thats only fifty percent of the time. Sorry for adding to the study for everything mess.
  I was one that reduced his riba by one pill to raise my hemoglobin from 80 to 110 the original was 180. You have to be careful though in these studies, for eg; my weight was 75 kgs, on the border of 1200 a day or 1000 , so I'd fit in both an 80%er and a full adherence I was told by the Dr's at Kingston that the growth factors should be avoided due to adverse side effects. The results of my six month post are not in yet though.
  There may have been that bleach stuff in their drinking water to eh.

Harry
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