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Tapering of interferon?
Several on the forum are familiar with the concept of tapering interferon at the end of trt, but it is new to me. I’ve seen some minor mention in recent posts about tapering and the rationale for doing this sounds reasonable and worth consideration.
For those not familiar, the idea is to slowly taper the interferon so your immune system can gradually return to normal, producing its own interferon and better identify any stray virons floating around at the end of treatment potentially avoiding what we all want to elude - relapse. The other concern is abruptly stopping the injections could lead to potential withdrawal issues and post tx symptoms such as rashes, depression, etc.
Sorry to rehash an old topic since it was discussed at length 2007-09 with a ton of posts. I’m only at week 14 of 48, so I have plenty of time to consider this as a possible option.
Are there any trials/publications to support the tapering of interferon? There seemed to be some strong opinions on both sides and I’m wondering if there is any new information to support the possibility of avoiding relapse due to the sudden removal of interferon. It didn’t sound like the tapering of riba was necessary due to its long half life. I guess the other issue is getting your GI/Hepa to agree with this concept and having your insurance approve it.
Any thoughts or opinions? Anyone do it or plan on it?
For those not familiar, the idea is to slowly taper the interferon so your immune system can gradually return to normal, producing its own interferon and better identify any stray virons floating around at the end of treatment potentially avoiding what we all want to elude - relapse. The other concern is abruptly stopping the injections could lead to potential withdrawal issues and post tx symptoms such as rashes, depression, etc.
Sorry to rehash an old topic since it was discussed at length 2007-09 with a ton of posts. I’m only at week 14 of 48, so I have plenty of time to consider this as a possible option.
Are there any trials/publications to support the tapering of interferon? There seemed to be some strong opinions on both sides and I’m wondering if there is any new information to support the possibility of avoiding relapse due to the sudden removal of interferon. It didn’t sound like the tapering of riba was necessary due to its long half life. I guess the other issue is getting your GI/Hepa to agree with this concept and having your insurance approve it.
Any thoughts or opinions? Anyone do it or plan on it?
Any thoughts or opinions? Anyone do it or plan on it?
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I gave you my best thought and opinion on this .not sure here who is giving advice.
"If one thinks there might be remaining virons, it seems to make sense to simply extend full treatment another four weeks or so rather than drop the riba and lessen the interferon. "
This sentence seems like advice to me on how much medication to take
As a matter of fact I would never give someone advice on or how much medication to take...as layman here I think that could be irresponsible and possibly dangerous.
best to you ..and yes flcyclist..it is always good to discuss.:).
Will
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I gave you my best thought and opinion on this .not sure here who is giving advice.
"If one thinks there might be remaining virons, it seems to make sense to simply extend full treatment another four weeks or so rather than drop the riba and lessen the interferon. "
This sentence seems like advice to me on how much medication to take
As a matter of fact I would never give someone advice on or how much medication to take...as layman here I think that could be irresponsible and possibly dangerous.
best to you ..and yes flcyclist..it is always good to discuss.:).
Will
Thank you for the feedback. Any yes, I'm not looking for advice from forum members, since I realize they aren't doctors/nurses, with maybe a few exceptions. However, some have considered this issue and might have valid reasons to consider it in tailoring their treatment protocol.
Although the idea has some merit, I agree that without the data from trials to support it, I'd be very reluctant to seriously consider it. I'm a bit surprised there have been no trials to explore this, along with some of the potential issues of abruptly stopping the inf injections.
Since riba has such a long half-life and takes months (?) to clear the system, my initial concern of abruptly stopping the inf and any stray virons rebounding could be mute. This is all very new to me, so thanks for indulging my curiosity.
Trish - the FL heat has created some challenges with heat/sweating and an angry rash which back under control. Actually, FL looks cooler than most areas north, so hope the heat wave leaves us soon. Other than that and some general fatigue, trt is going ok. Thanks for your thoughts. :)
Although the idea has some merit, I agree that without the data from trials to support it, I'd be very reluctant to seriously consider it. I'm a bit surprised there have been no trials to explore this, along with some of the potential issues of abruptly stopping the inf injections.
Since riba has such a long half-life and takes months (?) to clear the system, my initial concern of abruptly stopping the inf and any stray virons rebounding could be mute. This is all very new to me, so thanks for indulging my curiosity.
Trish - the FL heat has created some challenges with heat/sweating and an angry rash which back under control. Actually, FL looks cooler than most areas north, so hope the heat wave leaves us soon. Other than that and some general fatigue, trt is going ok. Thanks for your thoughts. :)
To my understanding, you weren't looking for advice...you were looking for input and discussion. I'm quite confident you have the ability to take the various contributions and come to your own credible conclusion together with your treatment team, who seem to have been doing a great job so far.
Personally, I'm not suggesting you should extend treatment to allay any concerns you might have for virons that are laying low. That might apply in some circumstances but in your case and in this thread, I'm merely talking theory and comparing approaches between tapering interferon vs extending treatment, if those concerns existed and were reasonable. I think you know that, but I figured I'd make that perfectly clear in general. As I've already said, I have not to date seen anything that supports tapering other than that one study and that's very vague to me and not credible enough on it's own, that was simply an abstract and the full study might show what their theory is based on.
Aside from that, I think what matters most is the results of PCR's you've had to date, your adherence record and what is known about treatment results based on those things. Hope you're managing the sides okay in this heat.
Trish
Personally, I'm not suggesting you should extend treatment to allay any concerns you might have for virons that are laying low. That might apply in some circumstances but in your case and in this thread, I'm merely talking theory and comparing approaches between tapering interferon vs extending treatment, if those concerns existed and were reasonable. I think you know that, but I figured I'd make that perfectly clear in general. As I've already said, I have not to date seen anything that supports tapering other than that one study and that's very vague to me and not credible enough on it's own, that was simply an abstract and the full study might show what their theory is based on.
Aside from that, I think what matters most is the results of PCR's you've had to date, your adherence record and what is known about treatment results based on those things. Hope you're managing the sides okay in this heat.
Trish
I would be very reluctant personally to give advice on whether to take more of a prescribed drug (especially one as powerful as INF.) without some clinical data to back up if there is a benefit or not.
The theory sounds plausible..however..why would it not be on the labeling ...was there any studies done?
There are many many people that post they are having serious long term side effects post treatment from all the INF. injected....personally I would want to have good data that supported it would help before I did even more than the prescribed amount...but thats just me.
Will
flcyclist : Of course using a vial for more them one shot would be ok. I meant don't re-use syringe.
Trish: My thinking was not to "catch remaining virons" but just in case any occult virus is lurking.
Of course to do this you had to be undetected all along otherwise just extend if you were a late responder.
I think it makes sense to allow the immune system time to slowly learn to "kill" virus on its own. After all it had help being amped up with interferon for 48 weeks and could be lazy when abruptly stopping the drug.
It just made sense to me, figured it couldn't hurt.
Trish: My thinking was not to "catch remaining virons" but just in case any occult virus is lurking.
Of course to do this you had to be undetected all along otherwise just extend if you were a late responder.
I think it makes sense to allow the immune system time to slowly learn to "kill" virus on its own. After all it had help being amped up with interferon for 48 weeks and could be lazy when abruptly stopping the drug.
It just made sense to me, figured it couldn't hurt.
Just a note on the overthinking stuff....I think that's my modus operandi...lol !! I'm still thinking about it when everybody's moved on to the next topic...still might be a dust bunny that has some info that might shed some light, you know? :) Might as well laugh at one's own foibles, eh? :)
All the best.
Trish
All the best.
Trish
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Have you looked at trough levels on the decreased dosage? With pegylated interferon, you might be exposing yourself to little or no interferon for some days of the week. I don't know the answer to this, but if you decrease your dose and your trough levels drop too far, you might be allowing virons to start reproducing once again. I think this is a risky approach. If you extend treatment another 4 weeks and taper during that period, you will have taken the prescribed dose for the proper duration and just be experimenting with the value of a taper.
Personally, I think interferon is so toxic that I wouldn't extend my treatment for one hour. I also wouldn't take a risk by dropping trough levels to the point where the virus could start reproducing once again. The very reason pegylated interferon was developed and is more potent than standard interferon, is that the trough levels remain high between doses.