SVR 24 Two Weeks After a Tripled Dose of Daclatasvir in an HCV Genotype 3 Patient
Canuck said
Jun 18, 2018
Hey sleestak,
um, where are all your old, old posts?? I was sure I remembred you from before, but, I see only two posts from you in recent times (and, you post here as a newbie)? Weren't you posting in the past as sleestak? ... Maybe I am just mixed up again. Regardless, (in both your recent posts), the data you brought forward was of interest. I see you like to read the studies. Me too.
No wonder it was justified for them to document this "one-off" case. Language barrier leads to the dosing mistake. Very odd, and unfortunate circumstance for this poor patient, and probably his very concerned docs. But turned out OK for the guy in the end, wonder how he made out with his future planned TB treatment! Smoother and more fool-proof I hope.
Talk about language barriers! The treatment facility/docs/study writers were ALL in Italy and/or converting between Italian and English, even the study reads a little funny/jilted - words/terms/measures are a little different (as studies go) - the patient (seemingly living in Italy now for a long time) uses no English (or Italian I assume) was Pakistani. Seems even with interpreters used, the error that happened could not be prevented.
He was a strange pt.! Being worked up for TB re-treatment, he is also deemed to be found to have HCV (exponential format viral load 0.162 x 106 IU/mL) = 162,000 IU/mL??. The TB which needs to be treated first, labs out of wack, showing high ALT/AST etc., but no apparent risk factors for HCV, no symptoms/complaints to speak of, was just a worsening of the TB the docs were wanting to investigate and treat, but, they find the HCV. Hm, long standing TB but BMI is high , and only thing of note was a little wgt loss? Weird! Oh well.
Just before HCV treatment his viral load (by that stupid exponential format) is down to 0.0301 x 106 IU/mL (=30,100 IU/mL?) - I think?. Somebody want to convert it? - be my guest! http://www.hepatitiscentral.com/hcv/viralload/ (Some of this link info is old).
Why are they using this exponential viral load format in Italy anyway! Regardless of it being hard to relate to/convert ... suffice to say the docs and study admit the viral load is low, and "very low" prior to SOF/DAC start.
His labs did get quite out of wack from the med error. "Full stop" by day 15. Labs normalized very quickly (I bet docs were glad) and oddly pt. had no HCV load since? Just weird. Possible I guess, low load, and triple dose of DAC for a real short course!
Had a GT3a buddy, on 24 weeks of SOF/DAC who "accumulated" too much DAC, no intentional overdose or med. error happening, just conditions in him that allowed the drug to accumulate in him, he started having uncomfortable sides, arrythmias and such, the longer the treatmnt went on the worse he felt, they didn't get it figured out until he was almost finished!, he was VERY well cured and never happpier to not have to ingest any more DAC (given his internal stockpile he had been storing)! It took a little while for his sides to improve after EOT, but they did.
DAC gets a bum wrap or ignored now with the likes of the newer DAA's in the front row, but still DAC has helped many a person and us 3's quite well. It still competes, and in some countries it is still what is most affordable and is quite effective.
Interesting study you posted sleestak - you should let us know more about you? I like your signature line and your reading list. C.
5-1-18 said
Jun 17, 2018
wow, wouldn't this be nice? treatment for less than a month
Tig said
Jun 17, 2018
Wow! I’m going to have to read up on that one. Holy cow, what an odd but fantastic result. I wonder what kind of things the patient experienced with that ultra Dac dose? I’ll have to research the Dac trials to see what the phase 2 studies prescribed. Interesting to say the least, thanks for sharing.
Thanks to the cultural mediator support, we explained to the patient the correct posology of each drug to take during the day consisting of 12 week SOF (400 mg daily) plus DCV (60 mg daily) regimen. He returned 13 days after for a programmed visit and we were surprised to learn that he had taken 3 pills of DCV (180 mg/daily) instead of one, thus ending DCV assumption after only 9 days while SOF was taken correctly.
At day 15 we stopped SOF closely monitoring the patient.
HCV viremia remained suppressed after 4, 12 and 24 weeks proving HCV eradication. If confirmed, these data could suggest that higher doses of DCV, if tolerated, might be employed in short-time HCV-GT3 treatment.
Hey sleestak,
um, where are all your old, old posts?? I was sure I remembred you from before, but, I see only two posts from you in recent times (and, you post here as a newbie)? Weren't you posting in the past as sleestak?
... Maybe I am just mixed up again. Regardless, (in both your recent posts), the data you brought forward was of interest. I see you like to read the studies. Me too.
No wonder it was justified for them to document this "one-off" case. Language barrier leads to the dosing mistake. Very odd, and unfortunate circumstance for this poor patient, and probably his very concerned docs. But turned out OK for the guy in the end, wonder how he made out with his future planned TB treatment! Smoother and more fool-proof I hope.
Talk about language barriers! The treatment facility/docs/study writers were ALL in Italy and/or converting between Italian and English, even the study reads a little funny/jilted - words/terms/measures are a little different (as studies go) - the patient (seemingly living in Italy now for a long time) uses no English (or Italian I assume) was Pakistani. Seems even with interpreters used, the error that happened could not be prevented.
He was a strange pt.! Being worked up for TB re-treatment, he is also deemed to be found to have HCV (exponential format viral load 0.162 x 106 IU/mL) = 162,000 IU/mL??. The TB which needs to be treated first, labs out of wack, showing high ALT/AST etc., but no apparent risk factors for HCV, no symptoms/complaints to speak of, was just a worsening of the TB the docs were wanting to investigate and treat, but, they find the HCV. Hm, long standing TB but BMI is high
, and only thing of note was a little wgt loss? 
Weird! Oh well.
Just before HCV treatment his viral load (by that stupid exponential format) is down to 0.0301 x 106 IU/mL (=30,100 IU/mL?) - I think?. Somebody want to convert it? - be my guest! http://www.hepatitiscentral.com/hcv/viralload/ (Some of this link info is old).
Why are they using this exponential viral load format in Italy anyway! Regardless of it being hard to relate to/convert ... suffice to say the docs and study admit the viral load is low, and "very low" prior to SOF/DAC start.
His labs did get quite out of wack from the med error. "Full stop" by day 15. Labs normalized very quickly (I bet docs were glad) and oddly pt. had no HCV load since? Just weird. Possible I guess, low load, and triple dose of DAC for a real short course!
Had a GT3a buddy, on 24 weeks of SOF/DAC who "accumulated" too much DAC, no intentional overdose or med. error happening, just conditions in him that allowed the drug to accumulate in him, he started having uncomfortable sides, arrythmias and such, the longer the treatmnt went on the worse he felt, they didn't get it figured out until he was almost finished!, he was VERY well cured and never happpier to not have to ingest any more DAC (given his internal stockpile he had been storing)! It took a little while for his sides to improve after EOT, but they did.
DAC gets a bum wrap or ignored now with the likes of the newer DAA's in the front row, but still DAC has helped many a person and us 3's quite well. It still competes, and in some countries it is still what is most affordable and is quite effective.
Interesting study you posted sleestak - you should let us know more about you? I like your signature line and your reading list.
C.
wow, wouldn't this be nice? treatment for less than a month
Wow! I’m going to have to read up on that one. Holy cow, what an odd but fantastic result. I wonder what kind of things the patient experienced with that ultra Dac dose? I’ll have to research the Dac trials to see what the phase 2 studies prescribed. Interesting to say the least, thanks for sharing.
Full Article; Annals of Hepatology
Thanks to the cultural mediator support, we explained to the patient the correct posology of each drug to take during the day consisting of 12 week SOF (400 mg daily) plus DCV (60 mg daily) regimen. He returned 13 days after for a programmed visit and we were surprised to learn that he had taken 3 pills of DCV (180 mg/daily) instead of one, thus ending DCV assumption after only 9 days while SOF was taken correctly.
At day 15 we stopped SOF closely monitoring the patient.
HCV viremia remained suppressed after 4, 12 and 24 weeks proving HCV eradication. If confirmed, these data could suggest that higher doses of DCV, if tolerated, might be employed in short-time HCV-GT3 treatment.
https://hepatitiscnewdrugs.blogspot.com/2018/06/svr-24-two-weeks-after-tripled-dose-of.html
-- Edited by sleestak on Sunday 17th of June 2018 11:51:30 AM