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[QUOTE=GLCII]Hi everyone

I have a question about pegasys.

I've done two treatments. One with the Interferon alfa 2b, one year, the other pegintron, one year. Neeless to say they both kicked my butt and both failed. The Doc I'm seening now (Dr Bennet Cecil) wants me to do two years pegasys. I'd like to know from someone who has done one or both of the first two and pegasys to tell me the difference in the sides. My first doc told me the sides of the first two TXs weren't bad :rolleyes: My current doc says pegasys is like taking water. ( I've heard that before) Can someone tell me the difference and how bad or good the pegasys sides are in comparision?

BTW I did respond to both of the first two TXs. Went neg both times. :D[/QUOTE]



Well, there are many here more qualified to answer on the side effects of Pegasys than am I, but I can confirm your suspicion that it ain't "like water." Pegasys has been shown in some studies to have somewhat lesser side effects than other interferons, but only somewhat. And, by the way, the one side effect that it does NOT beat the others on is death. I am not saying that to scare you--pegasys seems to me the best thing to have come along for us so far. But for a doc to so belittle the fact that it is very strong medicine with very important minuses to go with the pluses, is maddening.

Pegasys is a form of ifn 2a, slightly different from the two different versions of 2b you have had so far. There is a bit of evidence that it works better than its 2b sisters.

I assume you took ribavarin with the interferons. Everybody seems to hate riba, but the sustained response numbers with riba are measurably better than without, whether the ifn is pegylated or not. If you did not have riba --combo tx in other words--either of the previous two times, then it might be worth a third (!) try (I can't believe I'm saying this) with pegasys, just cause neither of your previous treatments was optimal in design.

On a separate track though, as much as I admire Pegasys, my understanding of the latest thinking on re-treatment (your situation), in fact the standard protocol now for re-treatment is consensus interferon, sometimes called cifn. (Infergen. It is made by Amgen) CIFN is available now in non-pegylated form, and may be coming soon as a Peg.

Not to disrespect Dr. Cecil's considerable reputation, nor to disrespect Pegasys--a great help to many thousands--I still think it is worth getting another opinion on his approach for someone who has already relapsed twice. An opinion of this approach as compared to trying cifn (infergen), I mean, or as compared to waiting for pegylated infergen, or even as compared to just waiting for something completely different.

Not to slight interferons, but your case doesn't seem very responsive to this medicine.

To further question the absent doctor, why two years? The reason the current recommendations of 24 weeks for types 2 and 3 and 48 for type 1 were adopted is that many attempts to get better long term reponse by extending treatment showed very little advantage, while increasing the risk of adverse events. So, why?

Life long maintenance is now being tried with some non-reponders, but I assume no one would suggest this unless liver damage was advanced and the risk of any more liver illness was much higher than the risks of a lifetime on such strong medicine.

Which naturally leads to the basic question: how's your liver? your health generally? Is fibrosis very far advanced? Is that why decided it was worth a second try at tx, and now a third try? Have you already exhausted your non-treatment options like giving up smoking, drinking, and eating healthy, losing weight, all the things we have learned can determine more about liver health than the virus does (in many, not all, cases)?

If you are trully ill, cirrhotic, symptomatic, or biopsies show your fibrosis advancing dangerously (say stage 3 or 4, or any stage of cirrhosis), then I guess you might do whatever, within reason. But otherwise, I think it's worth talking out, thinking out, what's it all about, before going forward.


My opinions only, of course. And, I am not a doctor, nor even a completely cooperative patient. So, read all you can, get whatever opinions you can, and decide for yourself.

Come back and let us know more.


sean





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