Thoughts on modifying dosing during treatment

[Go4SVR]

The literature which most of us read including this form indicates that there is reason to modify tx from the stock standard SOC (one treatment fits all). There has been a fair amount of discussion on this form especially regarding modifying Riba dosages for late responders and big boys. The tendency is to want to up the Riba dosage, which may be viable. But I came across a French test,
http://www.hcvadvocate.org/news/reports/AASLD_2005/11%2015%20treatment%20-4.htm
which indicates that Riba doesn

[Go4SVR]

Hi hightrekker,

That's the point, everyone is different in there response. 60 years old, 9 million to UND in 4 weeks on peg and only 800 Riba for all 180 lbs, is impresive until I got to the Type 2. You're in a fortunate genotype, if there is one. Well done on beating it.

Go4SVR

[ladybug52]

I didn't know your tx history, like so many people who have been here so much longer than me.
When I first came on, I visited many websites for hep c then stuck to this one pretty exclusively. I saw a picture of you with your fish tanks or what ever, (can't remember) and grandchild or something. (sorry for my vague recollection.)
Then I didn't see you post for quite a while, except occasionally. When you posted about tired of mh the first time, I thought it was a euphemism for some other website. Glad I found out it's for real, and I can find out more about results and tx of others.
I'm so curious as to how individualizing the SOC works out.
Thanks,
Bug

[fishdoc]

do an archive search for fishdocs consult, I went from 2.9 mil to 38,700 at my 12 week pcr, 180 peg, 1200 riba, went to hep researcher in albuquerque.. I did 60 wks, still clear at 1 month post tx pcr.  Some of us posted our bloodwork results at http://groups.msn.com/TiredofMHgroup, no one is really using that site anymore, it might be a good place for folks to continue to do that, just so people can compare...

[cruelworld]

so you snuck out three months early and apparently pulled it off.
im assuming the INF dose was standard per weight for the whole treatment.
again more positive anecdotal evidence of something as yet to be "proven"

[cruelworld]

thanks for that new info (to me) about riba having much more
positive effect when the viremia count is low and its relative weakness at higher viremia levels (at SOC dosing levels). i dont know of any newer studies that could discount this idea.
as far as "how much extra horsepower do we get out of high riba dosing" i beleive it is at least as much as similar increased INF dosing and will be proven so in the next few years. of course vertex beleives just the opposite (they support the french findings that once you are UND you dont need much and/or its not very important) i and some others beleive that more is better anytime in treatment. and the french study does not disprove this. since i dont expect vertex drugs to completely replace SOC overnight, i beleive SOC will be refined and tweaked over the next few years and the riba horsepower question will soon be answered.
there is an upcoming study for high riba dosing (8 a day) 1600 mg with standard INF dose which should be very revealing. is is a HIV coinfect crowd but the results will have the same meaning for us if not more. just the mere fact that this trial exists says that many beleive as i do, more is better. the answers are coming.

in the end i beleive that the exrta horsepower
of interferon is very costly in regards to both short and long term sides.
riba, on the other hand essentially has one major nasty short term side,
anemia. if this is tolerable to the individual, the extra horsepower is much less damaging and maybe even much less painful than INF overdose. of course all of this argument is based on free use of EPO as needed.



oh, make sure and vote for me. once i get SVR im running for president.

[Go4SVR]

Hi All,

Thanks for the feedback,
I agree that with the growing knowledge based from the evolving SOC that tx plans will become more targeted to specific response groups. No doubt we all know that UND is the first goal followed very closely with SVR. I

[fishdoc]

That site was created late last year because there was so much negative ****, no pun intended, going on here.  Chatting was prohibited, prosthelizing certain religious positions was rampant, and everyone complained about everything, threads disappeared daily- it sucked in general.  So that site was developed as an adjunct to this one, where people could gripe about mother in laws, poop thread to their hearts content, and post pics and documents.  The new format, and the loss of some of the most righteous members seems to have stopped a lot of that. I deleted my old spreadsheet, but will post the latest one.  Most of us that used it have gone on post treatment, but its still active and available, sorta for after hours stuff....

cheers.
c.

[hightrekker]

I think it is a matter of the person. I went from 9 million to UD in 4 weeks on 800 of ribi and standard peg.
And I'm male, almost 60, and weigh 180lb. We need to understand more. Type 2, infected in the 1970's.

[FlGuy]

The only good thing about being a relapser is that docs have a history of tx response to formulate a 'new' plan.  My docs agreed longer and stronger with an aim to get to und as soon as possible. So, I started riba early, increased the dose by 50% (to weight based) and doubled the peg for a few weeks.  But, for tx 1st timers you don't know what's in the box of chocolates. Astute docs will evaluate 'predictors', to the extent possible (like weight, age, damage, race) and come up with a  'personalized' plan.  I think docs need to be creative, patients need to have a handle and all involved come up with an agreed upon plan. And, to be willing to quickly adjust the plan based on patient-specific criteria. TX is not an exact science, but I think there are opportunities that can be explored.