Aa
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?
I don't have time to search for it right now but I think that Willing said there is now some good data to back up this theory . It was something that I just read recently, I think. I was looking up some information on predosing Riba and it might have been with that. Maybe Willing could post it again but he is feeling lousy these days on TX. Surely someone else will have also read it and chime in. I don't think I dreamed it up but I often can't recall where I read things.
Life induced brain fog. :>)
Ev
Life induced brain fog. :>)
Ev
I tapered off at end of my tx and felt it helped me attain SVR. This is to be done after all your regular shots are done.
I was able to get 3 extra doses of interferon, don't ask me how, you have to be creative :)
1st week 3/4 dose
2nd week 1/2 dose
3rd week 1/8 dose
Don't save and re-use any of the interferon, discard it and use new dose each time.
Best of luck
I was able to get 3 extra doses of interferon, don't ask me how, you have to be creative :)
1st week 3/4 dose
2nd week 1/2 dose
3rd week 1/8 dose
Don't save and re-use any of the interferon, discard it and use new dose each time.
Best of luck
Since Pegasys is also available by vial, couldn't you extract only what was needed rather than throwing out the remainder in the syringe? Can you do more than one extraction from the same vial without contaminating?
To all:
I don't like to overthink these things, but just exploring the options. Thanks for the responses.
To all:
I don't like to overthink these things, but just exploring the options. Thanks for the responses.
I'm going to bump this up so that maybe willing will see this.
I confess I don't get the logic of tapering interferon to ramp up our own immune system to catch remaining virons. 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. So on that note, I don't get the reasoning for it.
As for lessening the potential for depression, I'm not sure what to say about that. Post-treatment depression doesn't hit everyone so I'm not sure where that comes from. It's also relatively common in cancer patients also, not all of which are doing interferon. Not sure tapering helps there either....but not discounting it.
I never did see logic in tapering but then there's this study from 1996:
http://www.ncbi.nlm.nih.gov/pubmed/8707264
I haven't seen much else on the subject but Shiffman is no slouch and clearly they had some kind of theory that made them decide to study this specifically. I just don't know what it is. I've been involved with tapering discussions in the past and don't recall reading any information that stuck with me as supporting it but perhaps, as Evangelin notes, willing has some thoughts on the subject.
Good luck with your treatment and hope you're managing with the ups and downs of it okay....always rooting for you.
Trish
I confess I don't get the logic of tapering interferon to ramp up our own immune system to catch remaining virons. 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. So on that note, I don't get the reasoning for it.
As for lessening the potential for depression, I'm not sure what to say about that. Post-treatment depression doesn't hit everyone so I'm not sure where that comes from. It's also relatively common in cancer patients also, not all of which are doing interferon. Not sure tapering helps there either....but not discounting it.
I never did see logic in tapering but then there's this study from 1996:
http://www.ncbi.nlm.nih.gov/pubmed/8707264
I haven't seen much else on the subject but Shiffman is no slouch and clearly they had some kind of theory that made them decide to study this specifically. I just don't know what it is. I've been involved with tapering discussions in the past and don't recall reading any information that stuck with me as supporting it but perhaps, as Evangelin notes, willing has some thoughts on the subject.
Good luck with your treatment and hope you're managing with the ups and downs of it okay....always rooting for you.
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.