Ribavirin patients
Common Questions and Answers about Ribavirin patients
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The Arrival of DAA Therapy in the Pretransplantation Setting
The prescribing information for sofosbuvir also included an indication for use in the pretransplantation setting when combined with ribavirin for cirrhotic patients with hepatocellular carcinoma, who meet Milan criteria. The regimen is given and virus suppressed for up to 24-48 weeks in an effort to eradicate virus prior to transplantation and prevent reinfection of the graft after transplantation.
If you are on triple therapy for genotype 1 and undetectable then your doc is following AASLD protocol for anemia management
Anemia developed among recipients of both PIs. Hemoglobin decreases below 10 g/dL (grade 2 toxicity) occurred in 49% of patients who received a BOC regimen compared to 29% of those who received the SOC
regimen, whereas 9% had a hemoglobin decline of <8.5 g/dL (grade 3 toxicity).
Fifty patients with chronic hepatitis C virus (HCV) infection genotype 1 were randomly assigned to groups that were given peginterferon alpha-2a, with or without ribavirin, for 4 weeks; all patients then received an additional 44 weeks of combination therapy. First- and second-phase viral kinetics were evaluated.
Ribavirin therapy is contraindicated in women who are pregnant and in the male partners of women who are pregnant. Female patients receiving ribavirin and the partners of male patients receiving ribavirin must avoid pregnancy, using at least two reliable forms of contraception, during treatment and for 6 months after completion of treatment.
Good Luck
Impact of reducing peginterferon alfa-2a and ribavirin dose during retreatment in patients with chronic hepatitis C.Shiffman ML, Ghany MG, Morgan TR, Wright EC, Everson GT, Lindsay KL, Lok AS, Bonkovsky HL, Di Bisceglie AM, Lee WM, Dienstag JL, Gretch DR.
Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA 23298, USA.
No safety events in the DMC review were considered significantly different from those expected from HCV patients taking pegylated interferon and ribavirin treatment. The committee expressed no safety concerns that would preclude enrollment of the remaining 300 patients in the ongoing phase 2b study in the HCV positive genotype 1 and 4 population, and have not recommended modification of dose or duration of any RG7128 dosing regimens.
“Key agents used in HCV genotype 3 patients are [Sovaldi (sofosbuvir, Gilead Sciences)], combined with ribavirin, [Daklinza (daclatasvir, Bristol-Myers Squibb)] or velpatasvir (Gilead Sciences)],” the researchers wrote. “The comparative efficacy of individual combinations is largely unknown, mainly because of the paucity of head-to-head trials, while that information is necessary to steer guideline developmental and clinical decision making.
A Ribavirin Pregnancy Registry has been established to monitor maternal-fetal outcomes of pregnancies in female patients and female partners of male patients exposed to ribavirin during treatment and for 6 months following cessation of treatment. Physicians and patients are encouraged to report such cases by calling 1-800-593-2214.
Ribavirin may cause Birth Defects or Death of your unborn baby. Do Not Take Ribavirin if you or your sexual partner is pregnant, or plan to become pregnant.
He also recommended that I take an AD as he has had patients who at a higher dose experienced depression and riba rage.
Serum levels of interferon were more frequently below the level of quantitation in patients treated with peginterferon alpha-2b plus ribavirin (58-68%) than in those treated with peginterferon alpha-2a plus ribavirin (1-2%). Patients treated with peginterferon alpha-2b plus ribavirin had higher rates of discontinuation for safety reasons (6%vs 1%).
High Ribavirin? I am thinking about trying tx in a clinical trial with high riba. (about two times normal).
It seems like a lot of people here who did clear with SOC had more side effects than those who did not clear. I had few side effects but also did not clear. Maybe its the riba
I thought jmjm530 cleared using lots of Riba?
Anyone else do this or have thoughts?
If you are talking about Hepatitis C treatment, Pegasys is NOT given by itself for treatment naive patients. Pegasys is given in conjunction with Ribavirin for Genotype 2 and Genotype 3 patients. Pegasys is given in conjunction with Ribavirin and a Protease Inhibitor (either Incivek or Victrelis) for Genotype 1 patients.
"Due to the intensity and major side effects of the Incivek, it has been advised to start with the interferon/ribavirin treatment.
A study of nearly 2,000 patients showed that adding ribavirin to the combination of ledipasvir and sofosbuvir had no benefit in treating hepatitis C.
Patients taking ribavirin along with the combination were more likely to have adverse side effects to the treatment.
The drug approved to treat patients infected with the hepatitis C virus needs no help from other antivirals, according to a study released online this week in the journal Hepatology.
One study demonstrated that in patients with genotype 2 and 3 treated with the standard, fixed-dose ribavirin (800 mg/day), SVR rates were greater in the patients who were exposed to the higher mean dose of ribavirin, based on body weight [20]. Similarly, other studies have found an association between higher average doses of ribavirin per kilogram of body weight and higher SVR rates[10,11].
SVR was achieved by 76% (243/320) of patients with ribavirin dose reduction in the T12PR compared with 72% (408/565) of patients without ribavirin dose reduction in the T12PR."
Conclusions:
In patients treated with telaprevir-based therapy, anemia as well as ribavirin dose reduction had no apparent effect on SVR rates. These data suggest that management of treatment-related anemia with ribavirin dose reduction appeared not to impact SVR with telaprevir-based therapy.
To monitor maternal-fetal outcomes of pregnant women or female partners of male patients exposed to ribavirin, a Ribavirin Pregnancy Registry has been established. Healthcare providers are encouraged to register patients by calling 1-800-593-2214 (USA).
The manufacturer recommends the use of at least two reliable forms of effective contraception during treatment with ribavirin and during the 6 months after completion of treatment.
Impact of ribavirin dose reductions in hepatitis C virus genotype 1 patients completing peginterferon alfa 2a/ribavirin treatment. Clin Gastroenterol Hepatol. 2007;5:124 129.
23. Shiffman ML, Ghany MG, Morgan TR, et al. Impact of reducing peginterferon alfa 2a and ribavirin dose during retreatment in patients with chronic hepatitis C. Gastroenterology. 2007;132:103 112.
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