What is concensus interfergen?

[gauf]

UH oh,  Doc prescribed pegusys and script is in.  Is concensus interfergen better for a relapser? What is the difference?

[gauf]

I am a 2b. Biopsy showed stage 2/3, but doc thinks I am more like 3/4 compensated. I had a baseline VL of 800,000. Treated with pegasys and 800 riba for 3 months. Was UND at 12 weeks (EOT).Had to stop do to infections and wbc.  6 mos later relapse VL of 250,000. Retreated pegintron with 1000 riba for 24 weeks. Was nearly 100% compliant. UND at 12 wks, and EOT.  6 mos post relapse VL at 4million. The 2nd round was brutal and seems to have made things worse. If I have to do this again, I want to do it right.

[jmjm530]

The other thing is that depending on how much liver damage you have, you might want to set up some "stop" rules before starting.

For example, if you have little or no liver damage, you might want to stop at week 4 if not UND to preserve yourself for future trials or the newer drugs when they hit the market. Conversly, if you have a lot of liver damage, then a more agressive approach is in order. If you're somewhere in middle with liver damage, then it becomes a real judgement call.

-- Jim

[jmjm530]

Really not that familiar with re-treatment protocols for genotype 2's or 3's. Perhaps that's all you need -- more riba and 48 weeks -- assuming you treated 24 weeks the first time, but not sure. When did you go UND the first time around? If you went UND by week 4, then extending treatment may be more important than double-dosing. However, if you were a slower responder, then maybe double-dosing might be the ticket. A good hepatologist who believes in individualizing treatment would know best. Glad to see you still have the fighting spirit.

-- Jim

[gauf]

Thanks Jim, Yah I am the one with the by the book doctor.  I live an hour west of Cleveland, Oh. My doc simply plans on upping my Riba from 1000 to 1200, and extending tox from 24 to 48 weeks.  I am determined to double dose so I may have to shop elsewhere. -Geof

[Lonestar823]

Yes, Jim.  It's looks like you're the poster on my screen as well.

[jmjm530]

But I'm NOT. LOL.

[jmjm530]

At least on my screen, my name appears as the author of this thread, but "Gauf" is the author. Is this the way it appears on anyone else's screen? Strange.

[jmjm530]

Gauf: I suppose if she won't work with me I will have to look elsewhere.
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Please do. You do not want to double-dose, or for that matter alter treatment without your doctor's approval and supervision. I hope I'm not confusing you with someone else, but if you're the one with the doctor who "treats by the book", what you need the second-time around is a doctor who will carefully analyze why your treatment might have failed the first time, and then make reasonable adjustments the second time. Repeating the same treatment again -- or simply changing the pegs -- is not enough.

I know you're ready to get started, but a lot easier to find the right doctor to work with so both of you will be in sync once things get started. Ideally, you will work with a hepatologist who has had a lot of experience in treating relapsers and non-responders. If you post the general area you live in, maybe someone here knows of someone good.

-- Jim

[gauf]

Thanks Jim, I don't see the doc for another 3 weeks. I am formulating my best course of treatment for myself and will present it to her at that time. Don't know how she will respond. She is an infectious disease m.d. Thought she was a hepatologist, but think I was wrong. I have decided to double dose once a week after reading the replies to my post. I suppose if she won't work with me I will have to look elsewhere. The scripts are in though so hope it works out. Most concerned with talking her into the heptimax test. Tried that last time and was denied. never did give me a reason, and I was too sick to argue.

[jmjm530]

Consensus interferon (CS)has its admirers and detractors. From what I remember, Schiff doesn't seem to be a big fan of CS per the Clinical Options presentation posted earlier in the week by Mike Simon. You might want to listen to it.

You mentioned double-dosing in an earlier post. Did you discuss it with your doctor yet? Individualizing treatment is the way to go, especially in the case of relapsers, but it's really important you have a doctor who will work with you on this. Some of us make some minor changes/suggestions on our own, but it's a whole lot easier and more effective (not to mention safer) when your doctor is 100% on board. I did what some might consider unorthodox treatment decisions, but my doc always knew what I was up to and carefully monitored my progress.

-- Jim