Idenix Pharmaceuticals (IDIX)

[gofishmarko]

re: side effects of hep c tx

Thanks for the link. From the article:

" In the registration trials of peginterferon combination
therapy, significant side effects often required dose reductions and occasionally discontinuation of therapy. Because
most of the side effects associated with treatment are
dose related, this strategy has been proven to be a safe and
effective way to decrease adverse events and minimize
serious, life-threatening sequelae. However, recent interest
has focused on the importance of adherence to a prescribed
medication regimen in maximizing response to
antiviral therapy. Decreased adherence due to dose reductions or premature discontinuations could underestimate
the true effect of combination therapy for hepatitis C. "


The above is obviously also true for any new drugs being tried in combination with ifn/riba , and something we should keep in mind when looking at the resulting side effect profiles. I've looked for studies that examined the relationship between SVR and certain AEs and haven't found much , except for one that showed a statsig positive relationship between development of autoimmune hypothyroidism and SVR while on pegifn/riba therapy. Side effects that could be a marker of reversal of immune tolerance might be an early signal of a successful tx. , and it would be a shame if patients ( and docs ) are not made aware of this before treatment begins and encouraged to try to hang in there if at all possible. There is the danger of managing side effects so well that patients enjoy being treated but none of them ever achieve SVR.

More from the paper :

"Future studies should emphasize the importance of developing
additional management strategies that will maximize
adherence to antiviral therapy. Prospective studies
of adherence could evaluate the impact of early versus late
dose reductions and the effects on response in different
genotypes.

Prospective studies of hematopoietic growth factors to
determine their effects on sustained virological response
and quality of life and refining guidelines for dose reduction
for neutropenia may also improve the management
of adverse events during therapy with peginterferon and
ribavirin for chronic hepatitis C."

...