Lancet News on Interferon

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Lancet News on Interferon

Postby Gonzo » Fri Oct 22, 2004 3:57 am

Hi,

Might be of interest.

> Lancet Article
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Postby Outlawbiker » Fri Oct 22, 2004 9:20 am

So according to this study, a SC dose of the 44 mcg of Rebif ONCE a week would be enough? I hate needles and I can't help but wonder how or why Sereno came up with the 3 times per week dosage? Could it be for the $$
Dx RRMS 10/2000

Avonex-2000-2002
Rebif- 2002-present
Provigil- 2001-present
Baclofen- 2000-present
Lipitor(statin)-2002-present
Celexa
relapses since 2000------ZERO!!!!!
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Postby JFH » Sat Oct 23, 2004 4:14 am

Ob

I noticed that too. I've a neuro appt this week to decide which of the CRABs I start on, I'll pass this by him and see what he says and post back if it is significant. (The cynic in me whispers he will say words to the effect - You must follow the instructions on the label!)

Did you get into the Lancet article (passworded through the links I followed) to see SC 44mg, the abstract suggests just 22mg?
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Postby Outlawbiker » Sat Oct 23, 2004 9:32 am

I did catch the 22mg and am wondering if that's just a misprint. That's a huge amount compared to what Sereno and Biogen are pushing. Even the "high dose" 3*wk dose doesn't add up to 22 mg!

Maybe that new "Full disclosure" legislation with regard to studies in the development of new drugs could also be applied to an even closer look at FDA approved drugs. For example; What are the amounts of drug in question that would provide significant therapeutic effect with the lowest amount of adverse/side affects or disruption in other physiological functions of the user. My guess('s) might seem cynical but I wouldn't be surprised to find out they were right on the $$$

Give us the absolute minimum effective dosage in order to require more injections so they can keep prices high and demand high for the product.
while knowing that a higher less frequent dose would deliver equal or even better results with less (frequent)discomfort. I suppose the asking price per injection would have to skyrocket to astronomical levels to justify the way they've been raping those suffering with MS.
Dx RRMS 10/2000

Avonex-2000-2002
Rebif- 2002-present
Provigil- 2001-present
Baclofen- 2000-present
Lipitor(statin)-2002-present
Celexa
relapses since 2000------ZERO!!!!!
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Postby JFH » Sun Oct 24, 2004 1:22 am

I've managed to get sight of the orginal paper which says
Patients were randomly assigned, in blinded fashion, with a computer generated list at Quintiles (Sydney, Australia), to receive either 22 µg of interferon beta-1a (Rebif, Serono, Geneva, Switzerland) or identical placebo once a week by subcutaneous injection.
Not sure having skimmed through the paper that the use of Rebif 1/7 can be generalised to all users with RRMS.

I too worry that the determination of frequency and quanity of DMD that we should take seems rather arbitrary. There's another thread here that talks about Copax every other day instead of daily with results, if they are to be believed, that show no statistically significant difference - expect perhaps to the manufacturer's bottom-line!

Filippi's last paragraph with my emphasis
This study has confirmed in a large cohort of patients at the earliest clinical stage of multiple sclerosis that brain parenchymal loss takes place rapidly, and has shown that 22 µg interferon beta-1a, given subcutaneously once weekly, can alter this process significantly. Whether higher or more frequent doses would enhance or reduce this effect remains untested. The weak correlation between new lesion formation and brain volume reduction suggests that, even at the earliest clinical phase of the disease, inflammatory demyelination is not enough to fully account for irreversible tissue loss in multiple sclerosis.
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Postby Outlawbiker » Mon Oct 25, 2004 8:48 am

Nice work there JFH! So...... the 1/2 dose of Rebif SC/WK would be enough?!!! Maybe they had to do all the wrangling in order to convince the FDA to let them sell in the US despite Biogens protected status for the Avonex. All the while knowing full well that a low dose SC injection per week was as effective as all the other B.S.

So much wasted research $$ used to perpetuate the raping of the afflicted under the guise of trying to find "the cure."

Massive global reform is needed.
Dx RRMS 10/2000

Avonex-2000-2002
Rebif- 2002-present
Provigil- 2001-present
Baclofen- 2000-present
Lipitor(statin)-2002-present
Celexa
relapses since 2000------ZERO!!!!!
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Postby bebe » Wed Oct 27, 2004 3:23 pm

Wait a minute guys....dont be so quick to think so negatively about drug company intentions. This study (ETOMS) was done a long time ago, before there was proof of a dose-response with interferons (before PRISMS). This author is simply doing a analysis of brain atrophy on those patients. The original goal of the trial was to see if 22mcg of INFb 1-a would delay the conversion to clinically definite MS. It showed it did. This was in patients with clinically isolated syndrome, not in patients with confirmed MS. So, when you look at a different patient group- patients with established MS and an EDSS from 0-5.5, like in the PRISMS trial, you see a tremendous difference in outcomes between patients taking a low dose vs. a high dose. This was also confirmed in the head to head trial between Rebif and Avonex. There is a tremendous body of literature out there now to support this.
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Postby Outlawbiker » Wed Oct 27, 2004 6:45 pm

:cry:

I'm just soooooooooooooo sick of sticking myself.
Dx RRMS 10/2000

Avonex-2000-2002
Rebif- 2002-present
Provigil- 2001-present
Baclofen- 2000-present
Lipitor(statin)-2002-present
Celexa
relapses since 2000------ZERO!!!!!
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skin patch?

Postby batpere » Thu Nov 25, 2004 1:29 am

> I'm just soooooooooooooo sick of sticking myself.

Ditto. I became needle-shy after 5 years and my wife finally started
doing the injections when it was taking up to 20 minutes to work
up the nerve to do it myself.

Oral versions keep being mentioned, but why never a skin patch? My
wife has a skin patch for hormone replacement. Since the skin is where
the subcutaneous injections go, why not the transdermal approach
instead? I asked my first neuro about this, only to be told that "smart
people" would have already thought of this if it were possible. But I have
never heard this mentioned anywhere. This would be the ultimate
solution for me. Even a daily skin patch would be acceptable (although
my wife complains when they get ripped off).
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I think..

Postby Outlawbiker » Thu Nov 25, 2004 12:29 pm

The problems with oral treatments were due to poor absorption and unacceptable serum levels. On another front, the interferons caused too much irritation to the digestive tract. I suppose the same thing would happen in a transdermal patch.

Hey! The drug formerly known as Prince (JK! LOL) Antegren has gotten the green light early. I think I'm going to jump on that bandwagon as soon as the Veterans Administration says O.K. My neurologist is always complaining about what the cost of it will be. I currently receive a monthly supply of Rebif and the difference between what that costs and the single monthly dose of the Antegren is negligable. Just eleven needle sticks less per month!!!

BRING IT ON!!! :twisted:

(If anything above is mispelled it's because the spell check feature here sucks or I'm having one of those scarce moments of actual lucidity!)
Dx RRMS 10/2000

Avonex-2000-2002
Rebif- 2002-present
Provigil- 2001-present
Baclofen- 2000-present
Lipitor(statin)-2002-present
Celexa
relapses since 2000------ZERO!!!!!
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Location: Upstate New York


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