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TOPIC: Ademetionine and liver fibrosis

Ademetionine and liver fibrosis 2 years 6 months ago #22767

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On of the interesting things about seeing patients from around the world is getting exposed to things that are being used elsewhere that are not in (say) Australia. Yesterday I had a patient from the Ukraine who was on something called Ademetionine - never heard of it so looked it up.....

Heptral (ademetionine) in patients with intrahepatic cholestasis in chronic liver disease due to non-alcoholic liver disease: results of a multicentre observational study in India.

www.ncbi.nlm.nih.gov/pubmed/25154164
YMMV
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Ademetionine and liver fibrosis 2 years 6 months ago #22816

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Thank you for this info , Dr.
Is mechanism of action of this medication such that it is benefitial for cholestasis symtoms only or is it good for liver health in general ?
Diagnosed September 2016.
1b
ALAT in 40s.
VL 460 000
Fibroscan 12.5
Start of treatment 18/10/16
Wk 2 VL 145
Wk 4 VL detected unquantifiable
Wk 8 VL detected unquantifiable
Wk 12 undetected
week 30 after eot - undetected
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Ademetionine and liver fibrosis 2 years 6 months ago #22830

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The literature suggests it has utility for any cause of fibrosis.

It's not western mainstream but we don't know everything!
YMMV
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Ademetionine and liver fibrosis 2 years 6 months ago #22912

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According to Drugs.com, ademetionine (generic) is SAMe, and SAM-e.

www.drugs.com/international/ademetionine.html

Just did a quick google search. It appears SAMe is fairly cheap and widely available as a nutritional supplement (no prescription required) in the US.

Hmmm....
Failed Interferon 96', G1a, VL = 9 - 5.5 Million, F3/A3, AST 111, ALT 190, Generic DAA treatment Sof/Led (Mylan - India MYHEP LVIR) - 8 June, 2016
2 Week Results 20 June, 2016 AST 19, ALT 32
4 Week Results 06 July, 2016 AST 22, ALT 30, VL = 35
6 Week Results 20, July 2016 VL only = HCV RNA Detected, Non-Quantifiable <15
8 Week Results 04 August 2016, Labs, LFTs Normal, VL = UND
12 Week Results 31 August, 2016 LFTs Normal, VL = UND
EOT + 4 Weeks, LFTs Normal, VL = UND, "SVR4"
SVR12, 21 Nov 2016. CURED!!!
Last Edit: 2 years 6 months ago by fitz.
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Ademetionine and liver fibrosis 2 years 6 months ago #22913

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fitz wrote:
According to Drugs.com, ademetionine (generic) is SAMe, and SAM-e.

www.drugs.com/international/ademetionine.html

Just did a quick google search. It appears SAMe is fairly cheap and widely available as a nutritional supplement (no prescription required) in the US.

Hmmm....

Don't waste your money and don't believe everything you read on the internet. Many supplement companies grab a few good studies and they are everywhere. You never read about the BAD ones on HUMANS. Here are some treating only the liver. SAMe is used for many things. Expensive to because most studies say you need 800-1200mg a day.
www.ncbi.nlm.nih.gov/pubmed/22044287
www.ncbi.nlm.nih.gov/pubmed/14981985
www.ncbi.nlm.nih.gov/pubmed/19422296
www.ncbi.nlm.nih.gov/pubmed/16965225 Cholestasis is somewhat reduced with supplemental SAMe
An increase in the time taken to achieve a virological response was reduced, and SAMe is thought to confer an anti-viral effect with INTERFERON. www.ncbi.nlm.nih.gov/pubmed/20854821
Genotype 1A
ALT 473
AST 226
Virus Load 3,119,030
Results as of May-2016
5 week viral load/undetected as of 12/02/2016
Liver Biopsy Results from Feb 2013
Portal/Periportal chronic inflammation and mild interface hepatitis (Grade 2)
Focal Lobular chronic inflammation (Grade 1)
Portal/Periportal fibrosis (stage 1-2 trichrome and reticulin stains utilized)
Negative Iron stains.
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Ademetionine and liver fibrosis 2 years 6 months ago #22914

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Thanks for the thoughtful caution and information, Tommy.

Honestly, I'm not one who believes everything I read on the internet. On the other hand, I believe that contempt prior to investigation is bad policy (for me).

SAMe looks like it is genuinely worth investigating.

When I learned about Chlorcyclizine, I researched that as well. I've got a two month supply (unused) sitting in the original shipping box in the closet. Going a bit off topic here - at my own risk I gave it a try for a week.

Like Ademetionine, Chlorcyclizine is available OTC here in the US. Turns out Chlorcyclizine is very strong stuff, and I decided at the end of one weeks personal trial, the drowziness and horrible aftertaste were more than I was willing to put up with - especially since I was already well into a 12 week course of generic Sof/Led therapy.

Did the week on Chlorcyclizine help? I really don't know. Probably not, but maybe? I do know that after 12 weeks of generic Sof/Led therapy I am officially "cured".

Having lost entire joints to Hep C, and having borne the associated expenses, the $36 a month for 800+ mg of SAMe doesn't seem all that expensive. So, I'll look into it :)
Failed Interferon 96', G1a, VL = 9 - 5.5 Million, F3/A3, AST 111, ALT 190, Generic DAA treatment Sof/Led (Mylan - India MYHEP LVIR) - 8 June, 2016
2 Week Results 20 June, 2016 AST 19, ALT 32
4 Week Results 06 July, 2016 AST 22, ALT 30, VL = 35
6 Week Results 20, July 2016 VL only = HCV RNA Detected, Non-Quantifiable <15
8 Week Results 04 August 2016, Labs, LFTs Normal, VL = UND
12 Week Results 31 August, 2016 LFTs Normal, VL = UND
EOT + 4 Weeks, LFTs Normal, VL = UND, "SVR4"
SVR12, 21 Nov 2016. CURED!!!
Last Edit: 2 years 6 months ago by fitz.
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Ademetionine and liver fibrosis 2 years 5 months ago #22943

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Could it be good to take it alongside sof+led?
Diagnosed September 2016.
1b
ALAT in 40s.
VL 460 000
Fibroscan 12.5
Start of treatment 18/10/16
Wk 2 VL 145
Wk 4 VL detected unquantifiable
Wk 8 VL detected unquantifiable
Wk 12 undetected
week 30 after eot - undetected
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Ademetionine and liver fibrosis 2 years 5 months ago #22944

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At this point, (one man's non-medical layman's opinion) I would advise against trying the stuff (Ademetionine) while on DAA therapy since we don't know about possible interactions with DAAs.

I'm sure Dr. Freeman will be along with some actual medical guidance on this.

ETA: Here's a link to an interesting article on SAMe : www.journal-of-hepatology.eu/article/S01...(12)00409-6/fulltext
Failed Interferon 96', G1a, VL = 9 - 5.5 Million, F3/A3, AST 111, ALT 190, Generic DAA treatment Sof/Led (Mylan - India MYHEP LVIR) - 8 June, 2016
2 Week Results 20 June, 2016 AST 19, ALT 32
4 Week Results 06 July, 2016 AST 22, ALT 30, VL = 35
6 Week Results 20, July 2016 VL only = HCV RNA Detected, Non-Quantifiable <15
8 Week Results 04 August 2016, Labs, LFTs Normal, VL = UND
12 Week Results 31 August, 2016 LFTs Normal, VL = UND
EOT + 4 Weeks, LFTs Normal, VL = UND, "SVR4"
SVR12, 21 Nov 2016. CURED!!!
Last Edit: 2 years 5 months ago by fitz.
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