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“Failure with protease inhibitors is a special case that doubles treatment duration. ”
I have been inclined to agree with this all along but this is the first time I have actually heard a doctor say it. Any links that you can post on the subject would be much appreciated.
The Gilead Harvoni studies did not find that previous failure with a protease inhibitor made a difference to the 12 week duration of Harvoni tx. I do have previous failure with a protease inhibitor (telaprevir) and I have been suspicious that people are being palmed off with the 12 week duration because of the price of 24 weeks. I wonder if this has been done by Gilead in order not to lose the market of people who are protease inhibitor experienced.
Just because I’m paranoid does not mean they are not out to get me.
dt
PS
I meant to say “efficacy’, not “concentration” which may not be the same thing.Oh duh! I see that the prescribing info meant that both dac and led have many interactions with OTHER drugs.
I was thinking it meant they have many interactions with EACH OTHER.Anyway, I am still unclear on the subject of whether dac and led have interactions with each other. I cannot find any information which suggests that they do. I also cannot find any evidence which proves that they don’t. I want to know if the concentration of either drug will be lowered by the presence of the other during a switchover from led to dac, while keeping sof the same?
Possibly this is still one of the many as yet unanswered questions about using the DAAs.
dt
The manufacturer / distributor is CHATTEM Inc
Chattanooga, TN, USAI hope I just uploaded a pic of the ingredients on my bottle. It does not say lanolin, however if you are allergic then probably better to write to the manufacturer to confirm.
dt
Attachments:This is the one I have. I have never compared it to any others. It’s really an American product but luckily Amazon UK carries it. Watch out if the shipper is American as it takes about 2 weeks to arrive unless you pay for express shipping. I suppose that Ebay UK would also have it, probably from a US shipper.
dt
The tried and tested product for general skin problems and itching is Gold Bond lotion, available in the US. I have the Ultimate version with Aloe, but I think any version will do. It is not specifically for eczema and will not replace steroid cream if you have a rash, but for calming an itch and repairing dry skin it is numero uno.
dt
Hi Em,
Congratulations on finishing your first round of 12 weeks when hopefully all the heavy lifting has been done.
Good luck with your 2nd round of 6 weeks. I seem to remember that you have had minimal sides from the sof+dac in your first round. I’d be interested to see if your sides change at all as you extend your tx?
As we discussed before, I am going to extend as well. For how long depends on how well my body tolerates it as I go along, so any info on this would be most helpful.
dt
I got that b12 for under the tongue a few years ago. After using it for some weeks my lower front teeth got painfully sensitive. These particular tablets had some kind of fruit flavour which was acidic and leached the enamel on my teeth. I had to use an enamel repair toothpaste for a while to get rid of the tooth sensitivity.
dt
Yes 24 weeks is correct. I am doing it for the reason you say, ie. to hopefully ensure no relapse. I know it is an extra burden on the body that may not be necessary but I will monitor that and stop if I get into trouble. All the trials of these meds had 24 week arms and did not throw up safety issues which prohibited the 24 week duration being recommended for some people. Of course none of the trials included a switch of NS5A med in the middle, so that is an unknown. Somehow I don’t think I am going to find any more expert advice on it out there than I am going to find right here.
dt
Hi GAJ,
You raise a good point. I think the whole question of retreatment with the same or another NS5A is a thorny one given our current lack of knowledge about it. At this point in time I am not convinced enough about the possible success rate that I would want to do it. My liver is not bad, so I could wait if I had to for a better tx to come along for NS5A relapsers.
If I were to change my mind then there are other NS5As in the near future that could be used, meanwhile more data is coming in all the time. I guess the moral for now is – don’t relapse the first time. My hope is that adding 12 weeks sof+dac will ensure that, not sabotage it!
dt
That’s very interesting pkhow. There’s no way to tell the effect on the drugs’ efficacy during the switchover, but I would be interested to know if you had any side effects that you attribute to the switch? I suppose though that it would be hard to pinpoint the cause of a side effect at only 3 days in.
dt
Paul,
Thanks so much for your prompt and open-minded reply. I find that I am really nervous about asking this question, so go easy on me folks. I figure that if I can’t ask it here then I can’t ask it anywhere. You all have no idea how much deep doo doo I would be in if I mentioned this to my doc.
Actually, I suspect too that dac is better than led. I figure that if there’s any virus that the led did not finish off then the dac might, or even just the continuation of the sof will eventually get it. So I do have a clinical reason of sorts, but not one that I can substantiate any more than you.
It is the switchover that is worrying me, ie. the time that led is still in my plasma and dac is also coming on stream. In the unlikely event that they were to cancel each other out for a reason that I haven’t figured out, that would be most unfortunate. Maybe I should continue with the riba for a period during the switchover in case of this? Of course I would hate to do that.
dt
“In any case it would far exceed the cost of setting up and maintaing a World Wide Tx outcomes database,and at least the numbers would be there to start plotting some really meaningful charts.”
This is actually happening at a local level in the UK with plans to join up the data country wide. My local hospital asks for voluntary, anonymous participation in the collection of hepC treatment data. The understanding is that this data will be used to inform treatment in the future. It is however still early days and data collection takes time. The need for comprehensive data somehow always exceeds the availability of it.
Data collection was also done during the time that ifn + riba was all that there was. Over those years a lot was learned about how to refine the treatment. The fact that ribvirin action is still not fully understood is not because of a lack of data or failure to study it.
Anyway, I do agree that data collection is very important. What concerns me more is who has access to it, and how is it used? Give a statistician a database and you can get almost any conclusion out of it that you want. There are powerful interests out there who like to start with a conclusion and work backwards to the data needed to prove it. So if you are looking for unbiased, meaningful charts then they could be hard to get, but we have to try. If you are looking to get over the “insufficient data” condition, I don’t think that will happen any time soon.
dt
Gotta hand it to the politicians, they played a devious hand. In the end, all they really had to do was say NO to Gilead’s prices and turn a blind eye to the use of generics in their country. Then market forces prevailed. South Africa set the precedent years ago over HIV meds. Thus the world has been reminded for the 2nd time how it is done.
So to all the pussies sitting in positions of power out there, looking on while hepC meds are rationed and the worldwide hepC epidemic rages I say – get your act together. When Australia is declared free of HepC and the spotlight turns to questions on why your country is still infected, heads are going to roll.
I don’t doubt that none of this would have come about without the Doc and Greg’s courageous stance on the use of generics. This has been a momentous year for hepC treatment. I have lived through it myself. At the start of the year I had no prospects of obtaining the meds I needed. By the end of the year I had my meds, there were multiple choices of meds and trusted methods of obtaining them. When the books are written on how all this came to pass, those in the medical profession, the doctors, the specialists, who stood on the sidelines and refused to help, will be seen as yesterday’s men and women.
dt
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