Research supported antifibrotics - do they exist?

[Hepatitis Researcher]

The problems of treatment failure for SOC/IFN nonresponders and the possibility of reducing future supercombo-SVRchances by introducing archived resistance mutations when using "Pseudomonotherapy" - (that is here defined as using  a single  antiviral agent that is not protected against resistance development by its combo with an IFN/riba component (IFN by definition in this scenario is not sufficiently effective in reducing viral replication so that all the burden to tame the adaptive quasispecies evolution falls on the antiviral)) together with the 61% and 65% SVR rates for the latest triple modality in Geno 1s, have raised concern and the awareness for the need for alternate/additional treatment modalities in many HCV patients and their health care providers. Waiting for future antiviral developments is one route frequently recommended, but for the patients  in current need, our repertoire of additional meaningful approaches needs to be carefully reevaluated. Using antifibrotics to halt fibrosis progression is one concept not proven in large trials but it might well be effective in many, because the mechanisms for fibrosis generation are not intrinsically linked to HCV persistence, but rather to secondary response mechanisms evoked in the chronically inflamed liver, with the stellate cell activation holding center stage in this scenario. The following is one of several possible add on modalities.

[Forseegood]

guess I don't mind the occasional German...sorry...but I do think that Frijole's point about not wearing out Senor HR is a good one...not to be a hectoring Biaaach...but I think it's best to try and see if he's answered something first before asking (which I know is kind of tiresome considering the way this is laid out, but one should at least try - I think) so he doesn't end up answering the same questions over and over...I hope youre well Mike Simon...

[mikesimon]

When a post is in German and I translate it only to find there really wasn't very much to it I think things are maybe going just a bit too far.This is a public forum and don't we generally speak in English here so the vast majority will be able to understand? And I haven't anything against the poster or the German language. It is good for me to try to understand it but I will admit I needed to use a translation tool to really get it. I just thought someone should suggest that we lighten up a bit so I volunteered. Mike

[frijole]

Mike, I agree with you.  It seems (not on this thread) that there is some groupie mentality here and that its excess could run off anyone.
frijole

[Forseegood]

here, here....

[mikesimon]

I think we are so very fortunate that HR takes the time to share his knowledge and insight with us. I fear we members may impose upon him to the extent that he decides to refrain from participation in our discussions and that would be a huge loss to this board. I think we should be careful that doesn't happen. Mike

[mremeet]

I don't think HR is either subtly or overtly misleading us into believing that the substances he mentions are scientifically proven to provide benefit. He's only explaining (1) what some of the substances are, (2) the proposed theoretical mechanism of how it might work and (3) the low or essentially zero toxicity of the substances he mentions. He clearly states repeatedly that he does not have conclusive proof that these substances will positively slow, prevent or reverse fibrotic progression. He's simply making the best of what is now known and providing what could be lifesaving advice in the event the theory actually concurs with reality (there IS that possibility drofi!). In the meantime the substances are highly NON-toxic in the doses he recommends, and he also clearly stated to only take these substances under the supervision of a personal doctor (just to be on the safe side). He's been extremely responsible and we all admire and appreciate that he's willing to provide us with these thoughts. Everyone here knows there are no guarantees that what he's discussing will control or reverse their fibrosis or cirrhosis, mainly because he repeatedly says so, and says so clearly. As far as the $$ expense of these substances, I don't know much they cost but if I had cirrhosis and for whatever reason couldn't treat (or failed treatment), I'd spend a lot of money every year just for a reasonable and well thought out possibility that it might help to prevent my *death*, and to buy me more time until better treatment became available. If it turns out to be a waste of money, and all the theory turns out to have been for nought, in the truest sense of phrase - what difference would it make?