HCV News And The Turkey
Hello folks, and how is your day going? Its a cold chilly day here in Michigan, with Thanksgiving so close, yet so far away. To enhance your reading experience, or not, I added a little pre-turkey cheer.
Last weekend the grandkids and I made a turkey piñata to annihilate during the upcoming holiday. Later, Nana will secretly fill it with inappropriate candy - simply to annoy their parents.
Other then playing with paper mache, the boys, ages two and five, love to make action packed movies on my iPad.
Using this fun and easy app, short people can create an array of spine-chilling scenarios. On Saturday, the oldest was obliterated in his movie "The attack of the sea monster" and on Friday the baby blew up his turkey. I thought the latter, yet to be named, was a festive addition to today's post.
Last weekend the grandkids and I made a turkey piñata to annihilate during the upcoming holiday. Later, Nana will secretly fill it with inappropriate candy - simply to annoy their parents.
Other then playing with paper mache, the boys, ages two and five, love to make action packed movies on my iPad.
Using this fun and easy app, short people can create an array of spine-chilling scenarios. On Saturday, the oldest was obliterated in his movie "The attack of the sea monster" and on Friday the baby blew up his turkey. I thought the latter, yet to be named, was a festive addition to today's post.
In The News
Recently, a link to an Internet symposium discussing future HCV drugs presented at the 64th AASLD and a list of November newsletters were posted on the blog, here. Today we have a newsletter update, GI & Hepatology News the official newspaper of the AGA Institute just published their monthly newsletter.
We have two choices, either download the PDF or view the Interactive Version, I am an interactive gal myself. You may have read a few articles in the November issue, here are a few topics;
Sofosbuvir combo effective in unresponsive HCV
Coffee affects risk of liver vs. pancreatic cancer differently
Medicare may be covering HCV screening
HCV HUB
Readers may have noticed a promo in the GI newsletter for "HCV HUB." Check out the news section of the HUB here, videos here, and homepage here.Headlines At The HUB
Study identifies preferred approach to managing anemia from HCV treatment
The results of a randomized, open-label study suggest that reducing the ribavirin dose should be the "primary...
Over at Aidsmap coverage on this months liver meeting continues;
Sofosbuvir/ribavirin for 24 weeks cures most genotype 3 hepatitis C patients, adding interferon may help difficult-to-treat
A dual oral regimen of sofosbuvir plus ribavirin led to sustained response for 93% of genotype 2 hepatitis C patients treated for 12 weeks and 85% of genotype 3 patients treated for 24 weeks, researchers reported at The Liver Meeting 2013, the 64th annual meeting of the American Association for the Study of Liver Diseases (AASLD) held last week in Washington, DC. A related study found that adding ribavirin to this combination may be an option for harder-to-treat individuals.
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Faldaprevir plus pegylated interferon/ribavirin leads to early sustained response in people with HIV and HCV co-infection
The hepatitis C protease inhibitor faldaprevir plus pegylated interferon and ribavirin improved 4-week sustained response rates for HIV-positive people with genotype 1 hepatitis C co-infection in the STARTVerso4 trial, according to a poster presented at The Liver Meeting 2013 , the 64th annual meeting of the American Association for the Study of ...
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Daclatasvir + asunaprevir cures 85% of genotype 1b hepatitis C patients in Japanese study
An interferon- and ribavirin-free oral regimen of daclatasvir plus asunaprevir taken for 24 weeks led to sustained virological response (SVR12) in 85% of Japanese patients with hepatitis C virus subtype 1b, according to...
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Flu Season
Check out the CDC influenza activity map and see if influenza is in your area.
Probiotic pickled turnip touted as ‘flu wonder cure’
"Wonder cure for killer flu," is the headline on the front page of the Daily
Express. What the headline fails to tell you is that the "cure" – bacteria found
in suguki, a type of pickled turnip – has only been tested in mice…
New @ Medscape Medical News
"ECHO provides resource-efficient access to care for underserved communities," John Wong, MD, from Tufts University in Boston, told Medscape Medical News.
He presented the findings here at The Liver Meeting 2013.
The ECHO program, developed at the University of New Mexico Health Sciences Center, uses teleconferencing to help primary care physicians and specialists at the university comanage patients with chronic hepatitis C infection in 16 underserved rural areas and 5 correctional facilities.
Initial efficacy findings for 407 patients showed that the rates of sustained viral response at ECHO sites were nearly identical to those at university clinics (58.2% vs 57.5%) (N Engl J Med. 2011;364:2199-2207).
The cost is $3000; that's nothing, and the cure rate is as good as at a university.
Dr. Wong and his team compared the cost of pegylated interferon plus ribavirin with no treatment for each of 261 patients at the 21 ECHO sites. Mean patient age was 42 years, 73% were male, and 95% were white. A quarter had cirrhosis, 30% had moderate hepatitis, and 56% had genotype 1 hepatitis C.
Factored into the model were costs for office visits, lab tests, antiviral drugs, adverse effects, psychiatry, travel, productivity, and corrections personnel.
Compared with no treatment, the researchers projected that ECHO management would reduce the lifetime incidence of cirrhosis by 63%, decompensated cirrhosis by 46%, hepatocellular carcinoma by 45%, and liver death by 46%.
With ECHO, projected life expectancy would increase by 4.4 years, producing a cost saving of $12,200 without discounting for future disease costs. With discounting, ECHO had a cost of $9,000.
Compared with no antiviral therapy, the program saves money in 35% of patients overall, in 30% of patients in the community setting, and in 43% of patients in correctional facilities. Another 23% benefited with ECHO management, but some at higher costs. In 42% of patients, the treatment didn't work.
The incremental cost-effectiveness ratio — the rate of additional cost to additional benefit — was $3700 for the entire study population, $5800 for the community, and $1400 for the corrections facilities.
The incremental cost-effectiveness ratio reflects what the intervention costs to increase life expectancy by 1 year of perfect health (cost-quality-adjusted life-year gained). The World Health Organization considers an intervention to be very cost-effective if that ratio is less than the per capita gross domestic product of a country, and to be cost-effective if it is less than 3 times the per capita GDP, Dr. Wong explained.
"The mean per capita GDP in the United States is $50,000, so this is 10-fold lower, and therefore very cost-effective," he said.
Dr. Wong reported that ECHO now includes triple therapy and that he expects the much-anticipated polymerase inhibitor sofosbuvir and the protease inhibitor simeprevir to be added once they are approved by the US Food and Drug Administration. He said he anticipates that ECHO will be cost-effective as long as triple therapy remains effective.
Both session comoderators told Medscape Medical News that they are impressed with the findings.
"I think it shows that increasing access isn't costly, it's cost effective. The cost is $3000; that's nothing, and the cure rate is as good as at a university," said comoderator Sammy Saab, MD, from the David Geffen School of Medicine at UCLA.
"If the new hepatitis C drugs have a better safety profile, a lot of the treatment can be undertaken by primary care providers, which would be a huge boon for people," added comoderator Kiran Bambha, MD, from the University of Colorado Medical Center in Denver.
Dr. Wong and Dr. Bambha have disclosed no relevant financial relationships. Dr. Saab is a consultant to Bristol-Myers Squibb.
The Liver Meeting 2013: American Association for the Study of Liver Diseases (AASLD). Abstract 245. Presented November 5, 2013.
Also see
Costs for Hepatitis C Treatment Skyrocket
Hepatitis C and Diet
on November 14, 2013
One of the liver’s biggest jobs is to help us digest and metabolize what we eat. The liver processes fats, proteins, and carbohydrates, turning these into energy and other necessary components to keep us alive. Our energy levels depend on the liver’s ability to do its job...
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Off Topic
Medical Tourism: Rewards Not Without Risks
GSN Reporter Travels to Mexico To Speak With a Patient About Bariatric Surgery Gone Bad, and the Doctors Who Saved His Life
by Gabriel Miller
Juarez, Mexico—Before he lost his life savings; before he spent a month in the ICU and a year in and out of the hospital; before he was wheeled, in septic shock and on a ventilator, across the bridge at the U.S.–Mexico border; before all of this happened, in early 2008 Jose Sanchez decided to have his bariatric surgery in Ciudad Juarez, Mexico, and not in El Paso, Texas, where he’d been living since he was 15....
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Have to run, but will be back later if I notice any HCV updates.
See you all soon.
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