Hep C

stiri medicale; cazuri clinice
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Melania
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Hep C

Postby Melania » Wed Apr 27, 2011 2:29 pm

http://www.nature.com/news/2011/110426/ ... 56.html#B1

New drug targets raise hopes for hepatitis C cure

As the first targeted therapies edge towards regulatory approval, attention turns to the next drugs in line.

Heidi Ledford


A cocktail of tailored drugs will be needed to defeat the hepatitis C virus. Later this week, a panel of advisers to the US Food and Drug Administration (FDA) will decide whether the regulator should approve the first therapies tailored to target the hepatitis C virus (HCV). The drugs, called protease inhibitors, are expected to win approval, but observers say that they are only the beginning of a revolution in HCV treatment.

The most exciting developments for patients, they say, may still be in the drug-development pipeline. Researchers are working on drugs that target many aspects of the virus's biology. Used in combination, these might thwart HCV's ability to evolve resistance.

About 3% of the world's population is infected with HCV, an RNA virus that can cause chronic liver disease. Current therapy — a year-long regimen of the antiviral compounds interferon-alpha and ribavirin — cures only about half of cases. Side effects of this treatment can be severe: interferon-alpha can cause flu-like symptoms, fatigue, anaemia and depression.

On 27 and 28 April, the FDA's Antiviral Drugs Advisory Committee will meet to discuss the first anti-HCV drugs to target HCV proteins. Both these drugs — boceprevir, made by pharmaceutical giant Merck, headquartered in Whitehouse Station, New Jersey, and telaprevir from Vertex Pharmaceuticals, based in Cambridge, Massachusetts — target a protein called the NS3-4A protease, which is required to make essential viral proteins.

Each drug, when combined with standard therapy, boosts the cure rate to about 75%.

"I am very excited," says Michael Houghton, a virologist at the University of Alberta in Edmonton, who was a member of the team that discovered the virus in 1989. "These drugs are great news for HCV patients."

The long road to a blockbuster

Nevertheless, these drugs are only the beginning. "These first-generation protease inhibitors will enjoy their day in the sun for maybe two or three years," says Raymond Chung, head of hepatology at the Massachusetts General Hospital in Boston. "But I don't see them having staying power once we have many more of these targeted drugs getting into the game."

The hope is to eventually use several drugs in combination, avoiding the need for interferon-alpha while staving off drug resistance. Houghton estimates, based on mathematical models and clinical studies, that it will take a cocktail of three targeted therapies to prevent drug resistance.

There are about 60 compounds in preclinical and clinical development as companies jostle to grab a slice of a multi-billion-dollar market.

In 2010, researchers at Bristol-Myers-Squibb's lab in Wallingford, Connecticut, reported their discovery of an HCV protein called NS5A that is essential for the assembly of infectious viral particles and the amplification of viral RNA1. In early clinical trials of an NS5A inhibitor, the level of HCV RNA in the blood dropped almost 2,000-fold after only one day of treatment. This drug is now in phase 2 clinical trials.

Combining the NS5A inhibitor with a protease inhibitor wiped out the virus in four of 11 patients whose infections had not responded to standard therapy. The virus remained undetectable for at least 24 weeks.

These latest results, presented at the International Liver Congress annual meeting in Berlin on 1 April, are exciting because they suggest that interferon may eventually be dispensable, says Chung. He anticipates a flurry of such combination studies in the next few years.

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Another approach is to stop HCV spreading inside patients by targeting its ability to enter cells. "To contain the virus in a subset of cells rather than allowing it to spread would be a huge boost for containing liver damage," says Michael Gale, a virologist at the University of Washington in Seattle.

In a study published in Nature Medicine on 24 April, a team led by virologist Thomas Baumert of the University of Strasbourg, France, reports that HCV relies on a cellular receptor protein, the epidermal growth factor receptor (EGFR), to enter human cells2. EGFR inhibitors are already on the market as cancer therapies and Baumert's team plans to begin clinical trials of the EGFR inhibitor erlotinib in HCV patients by the end of the year.

Another drug that blocks entry, ITX-5061, is being developed by iTherX, a pharmaceutical company based in San Diego, California, and is in phase 2 clinical trials.


Chung, meanwhile, believes that drugs called nucleoside polymerase inhibitors, which prevent the virus from copying its genome, will be a key ingredient of any future HCV drug cocktail. These compounds set a high barrier for the virus, he notes, and early tests suggest that resistance to them is rare.

Pharmasset, a pharmaceutical firm in Princeton, New Jersey, has several such drugs in development. One called RG7128 is in phase 2 clinical trials and is being developed by Pharmasset together with the Swiss drug giant Roche, based in Basel.

"We used to live in a monochromatic world," says Chung. "Now we realize there are several roads to the same destination."

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Re: Hep C

Postby 187.92a » Thu May 05, 2011 12:54 am

tldr. anyone care a citit, ce zice?

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Re: Hep C

Postby pc7 » Thu May 05, 2011 5:26 am

New drug targets raise hopes for hepatitis C cure
De profesie observator.

"mania grandorii daca n-o ai, la medicina ce cauta n-ai " vlad s.
"latra-ti dusmanii, ca se zapacesc la cap" muma p

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Re: Hep C

Postby Melania » Thu May 05, 2011 6:52 am

Pai e o revolutie in trat Hep C, unde nu s-au facut progrese de la ribavirina si interferon; introducerea inhibitorilor de proteaza la terapia standard face ca trei sferturi din cei tratati (genotipul 1) sa fie vindecati iar tratamentul sa poata fi scurtat.
Inhibitorii de proteaza de prima generatie sunt inceputul schimbarii, urmeaza in doi ani cei de generatia a doua si inhibitorii de polimeraza, iar in viitorul nu foarte indepartat eliminarea interferonului si ribavirinei prin inlocuirea lor cu combinatii de molecule care tintesc diverse proteine virale.

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Re: Hep C

Postby Melania » Sat May 14, 2011 9:48 pm

Deci doua medicamente noi:
INCIVEK - Vertex Pharmaceuticals
VICTRELIS -Merck

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Re: Hep C

Postby ssss » Mon Jun 27, 2011 9:25 am

Nu costa mult, vreo 50 k primele 2 saptamani. Rezultatele sunt, intr-adevar, spectaculoase.
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Re: Hep C

Postby Melania » Tue Jun 28, 2011 7:54 am

Pai trebuie sa isi recupereze banii in timpul care le-a ramas pana la aprobarea inhibitorilor de a doua generatie. Costa 50 k pentru 12 saptamani.
Asigurarile acopera ceva din banii astia?

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Re: Hep C

Postby ssss » Tue Jun 28, 2011 11:38 am

acopera, ca nu au de ales.

oricum, in studiile initiale au gasit numai vreo 600 din jdemii de bolnavi, ceea ce te face sa te intrebi ce exclusion criteria au folosit.

vorbeam cu o repa de merk despre datele lor, si talking point-ul ei era ca e bine sa-i tratezi pe astia acum, cand sunt tineri pe asigurare privata, pana sa intre pe medicare(incredibil ce le beseste mintea la farma) adica le pasa de public burden :D

i-am spus ca in experienta mea imensa majoritate sunt bipolari si deja pe medicaid adica deja public burden(impresie confirmata si de colegii gastro, cel putin regional). mi-a aratat mirata ca In studiul lor nu erau asa de multi bipolari.

Problemele majore legate de boala psihica sunt generate de interferon( nici un gastro intreg la minte nu o sa dea interferon unui pacient cu depresie necontrolata, si psihiatrii nu vor sa vada pacienti medicaid) si de compliance, la una din buline e un program foarte ciudat, la ore fixe de trei ori pe zi si daca ai omis 2 doze s-a terminat toata treaba.
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Re: Hep C

Postby Melania » Tue Jun 28, 2011 11:56 am

Una din buline a avut in studii exclusion crt 'pre-existing psychiatric conditions' (pe clinicaltrial.gov nu dau mai multe detaliii) care citit asa pare destul de vag.

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Re: Hep C

Postby ssss » Wed Jun 29, 2011 1:15 am

:D chiar ca vag. there you have it. ii inteleg si pe ei, e normal sa vrei maximum de complianta si minimum de cefalee. realitatea in transee e putin diferita si mi s-a parut funny talking point-ul.

Pentru cei care nu stiu cum functioneaza farma, cineva in marketing vine cu o idee, dupa care le fac training/brainwashing la toti repii si-i pun sa regurgiteze orice tampenie pe care vreun tampit cu ceva autoritate o impune. 6 luni mai tarziu, alt tampit vine cu ceva diametral opus dar ei spera ca doctorii au memoria scurta. De exemplu, Glaxo a facut marketing agresiv impotriva aerosolilor cand vindeau discul cu pulbere inhalata. Dupa ce au vazut ca spitalele refuza sa cumpere discul, au venit si eu cu un spray.

Cu toate rezultatele(intr-adevar spectaculoase), am dubii serioase ca va avea un impact global cum a avut vaccinarea HepB. pana nu gasesc un vaccin pentru hepC, nu sunt sperante mari.
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Re: Hep C

Postby Melania » Wed Jun 29, 2011 8:26 am

Ai dreptate, au evitat pacientii cu probleme la mansarda ca sa se asigure ca au cat mai putini care renunta la trial; e normal sa fie asa, altfel nu poti sa tragi nici o concluzie.
Numarul de 600 de pacienti e iarasi un compromis intre numarul necesar pentru a face o statistica concludenta si bani. Costa enorm sa ai un pacient intr-un studiu din asta, mai ales ca trebuie sa platesti si costul IFN si ribavirinei pentru cateva luni bune, plus logistica, labs, doctori si alte alea.

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Re: Hep C

Postby ssss » Wed Jun 29, 2011 10:42 am

Pai asta zic, nu contestam validitatea studiului, doar nu incetez sa ma mir cum branchul de marketing consistently fucks up si tarasete in noroi pe ala de research, twisting data and stuff.

Guvro plateste tratamentul?
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Re: Hep C

Postby 187.92a » Wed Jun 29, 2011 4:12 pm

ssss wrote:Nu costa mult, vreo 50 k primele 2 saptamani. Rezultatele sunt, intr-adevar, spectaculoase.


daca scot astia si trat efeicient de hiv imi ralizez visul de a-mi face vasectomie si a merge la .... fara prezerv :)

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Re: Hep C

Postby ssss » Wed Jun 29, 2011 10:30 pm

Pai da, ca sifilisul e tratabil :twisted:
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Re: Hep C

Postby Melania » Sat Oct 26, 2013 11:44 pm

Simeprevir si Sofosbuvir aprobate de FDA. ;)

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Re: Hep C

Postby Chingachgook » Sun Oct 27, 2013 12:58 am

ai lucrat la vreunul?
Sunt cel mai pașnic om din lume. Dorințele mele sunt: o căsuță modestă, un pat bun si o gradina cu pomi. Iar dacă Domnul Dumnezeu ar vrea să mă facă într-adevăr fericit, as vedea spânzurați în acești pomi șase sau șapte din dușmanii mei...

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Re: Hep C

Postby Melania » Wed Oct 30, 2013 10:46 am

Bineinteles.:)

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Re: Hep C

Postby MumaPadurii » Mon Oct 05, 2020 3:05 pm

Ha.

https://science.hotnews.ro/stiri-stiint ... s-rice.htm

Ani de zile mai târziu, în 1989, Michael Houghton și echipa sa sunt creditați cu descoperirea secvenței genetice a virusului. Charles Rice este cel care a studiat ani de zile modul în care se replică virusul, lucrări care au condus la apariția unui nou tratament revoluționar în anii 2010.

Munca lor reprezintă "o realizare istorică în lupta noastră continuă împotriva infecțiilor virale", a arătat Gunilla Karlsson Hedestam, membru al Adunării Nobel care decernează premiile.

Este vorba de primul Nobel acordat pentru studii privind un virus din 2008.
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Re: Hep C

Postby Melania » Mon Oct 05, 2020 3:20 pm

Scriam in 2011, postul initial:

"I am very excited," says Michael Houghton, a virologist at the University of Alberta in Edmonton, who was a member of the team that discovered the virus in 1989. "These drugs are great news for HCV patients."

“Anii 2010” wtf?

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Re: Hep C

Postby MumaPadurii » Mon Oct 05, 2020 3:25 pm

Poate se refera la toata decada, cum ai zice "the ´20s".
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Re: Hep C

Postby M_Dan » Mon Oct 05, 2020 3:31 pm

Alta facatura a Big Pharma. Pretul enorm indica dorinta de profit maxim, desi costurile de productie pot fi sub zece dolari pentru un tratament. Nu este corect sa se lase pe mainle particularilor tratarea bolilor, trebuie ca sistemul medical sa fie controlat minim 80% de stat. Pentru asta trebuie ca populatia (votantii) sa nu fie tampita si sa faca presiune asupra politicienilor. Din pacate votantii sunt cretini, doar 1% din populatie are ceva in cap.

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Re: Hep C

Postby MumaPadurii » Mon Oct 05, 2020 3:37 pm

Nu doar 1%, ci 41%, cat e acum intentia de vot pentru Trump.

Ai prins dog whistle-ul pe care vi l-a lansat in debate-ul cu Biden, cand s-a laudat ca s-a luptat cu Big Pharma, sa scada preturile la medicamente?
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Re: Hep C

Postby Melania » Mon Oct 05, 2020 4:03 pm

M_Dan wrote:Alta facatura a Big Pharma. Pretul enorm indica dorinta de profit maxim, desi costurile de productie pot fi sub zece dolari pentru un tratament. Nu este corect sa se lase pe mainle particularilor tratarea bolilor, trebuie ca sistemul medical sa fie controlat minim 80% de stat. Pentru asta trebuie ca populatia (votantii) sa nu fie tampita si sa faca presiune asupra politicienilor. Din pacate votantii sunt cretini, doar 1% din populatie are ceva in cap.

Costurile de productie nu conteaza, conteaza investitiile in RD care sunt cu cateva ordine de marime mai mari. Doar pt biologice si terapii celulare costa putin mai mult productia in rest e peanuts.
La inceput tratamentul HCV costa cat un Maserati, acum costa cat un Renault. O sa scada pretul si mai mult.
In Maroc, Egipt etc costa f putin, cam cat o bicicleta pt ca au negociat cu pharma. La noi nu.

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Re: Hep C

Postby alimori » Thu Apr 14, 2022 11:19 am

Avem în Spania niște cazuri de hepatită gravă la copii de cauza necunoscută (scuzați offtopicul, se știe că nu e C, nici A, B, D sau E). Sunteți pregătiți pt o și mai nouă normalitate?
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Re: Hep C

Postby Melania » Thu Apr 14, 2022 11:42 am

Ciudat...si in UK s-au raportat cazuri.
https://www.ecdc.europa.eu/en/news-even ... ed-kingdom

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Re: Hep C

Postby MumaPadurii » Thu Apr 14, 2022 12:07 pm

Cica in UK ar fi inceput, apoi s-au raportat 3 cazuri si in Spania, dar ceea ce e ciudat, e ca se pare ca cele trei cazuri n-ar fi legate de calatorii.
Deci daca e un agent infectios, ar insemna ca exista deja transmitere intracomunitara, nu?
Ma gandesc ca daca exista deja transmitere intracomunitara si un numar atat de mic de cazuri, asta inseamna ca n-ar provoca complicatia asta decat in cazuri rare (sau la anumite persoane/grupuri de persoane) si in rest ar fi putin simptomatic.
Sau alta varianta, ca are un timp de incubatie mai mare si intr-o saptamana o sa ne trezim cu un numar foarte mare de cazuri. :)


Daca o fi vreo toxina din vreun aliment, ceva? Vreun supliment alimentar care se da copiilor sau vreun dulce contaminat cu vreun agent toxic sau infectios (ca tot a fost scandalul cu ciocolaticile kinder cu surprize de salmonella)?
Sau poate vreun supliment naturist (am citit de cazuri de hepatita toxica de la produse Herbalife) care e relativ inocuu pentru adulti, insa poate produce complicatia asta daca e dat copiilor...
Sunt o gramada de oameni care baga in ei tot felul de produse de detoxifiere, vitamine si suplimente naturiste. E foarte la moda practica asta si, avand in vedere ca ei au impresia ca sunt sanatoase si "naturale", nu mi se pare de necrezut sa le fi dat si copiilor.
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Re: Hep C

Postby Melania » Thu Apr 14, 2022 12:42 pm

Corect, dar daca ar fi fost un medicament/detoxifiant probabil ar fi fost mai mult sau mai putin comun in majoritatea cazurilor. Cum sa dai suplimente naturiste/detoxifiante copiilor? :?
Sa le fi scapat cazurile de salmonella? Banuiesc ca au verificat si asta si alti microbi, nush.
Poate e covid sau alt virus, de ce nu.
Concluzia e ca nu se stie, poate ne va lamuri vestitul grup de cercetatori britanici.

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Re: Hep C

Postby MumaPadurii » Thu Apr 14, 2022 1:05 pm

Nu ziceam ca-i salmonella, era doar un exemplu de contaminare.
Dar banuiesc ca primul lucru pe care-l fac in cazurile astea e o ancheta epidemiologica si si-ar fi dat seama daca era un produs comun cu care ar fi venit copiii in contact.

Melania wrote:Cum sa dai suplimente naturiste/detoxifiante copiilor?

De ce nu? Sunt sanatoase si n-au efecte adverse, nu?

The first study to look at the use of herbal supplements or medicinal teas in babies finds that about 9% of moms report using these remedies in infants under a year old.

The study, which is based on a nationwide survey of new mothers conducted by the CDC and the FDA, found that moms who used herbal supplements themselves were nearly four times more likely to give them to their babies than moms who didn’t use them previously.

https://www.webmd.com/parenting/baby/ne ... ments-teas

Children have developed seizures and infections from herbal teas and remedies, lead poisoning and mercury poisoning from traditional remedies, and liver damage from dietary supplements.

https://www.poison.org/articles/dont-gi ... to-infants

Si-asa le dau tot felul de prostii, am auzit de bebelusi veniti la urgente ca fusesera hraniti cu sarmale sau de un caz de carotinodermie la un bebelus caruia-i dadea maica-sa trei sticle de Teddy pe zi. Ca Teddy e sanatos, nu?
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Re: Hep C

Postby alimori » Thu Apr 14, 2022 1:08 pm

Au zis deja că n-are legătură cu covid.
Sper sa fie vreun insecticid ceva. In urma cu 3 ani Franța a făcut o anchetă pt că se nășteau copii cu malformații d membru superior cam des. Eu lucram de 2 ani la copii și avusesem deja vreo 2 cazuri, la fel și colegele mele. In Franța erau dintr-o zonă anume. Se pare că fusese un insecticid din agricultură.
Acum sunt cazuri împrăștiate pe peste tot și de vârste la care nu se mai dau formule de lapte ca să suspectezi vreun lot contaminat.
Sper sa nu fie vreun "agent infectios nou" că n-am nervi să mai rabd încă o pandemie.
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Re: Hep C

Postby pc7 » Thu Apr 14, 2022 9:31 pm

Fk, credeam a e hep A cand am citit acu vreo 2 zile. Acu sunt cazuri si in sp? Bpl, chiar nu mai luam si noi pauza?
De profesie observator.

"mania grandorii daca n-o ai, la medicina ce cauta n-ai " vlad s.
"latra-ti dusmanii, ca se zapacesc la cap" muma p

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Re: Hep C

Postby Melania » Tue Apr 19, 2022 12:31 pm

Reguli de igiena; acelasi sfat l-am primit si cand a inceput pandemia de coronavirus.
Cand nu stii ce sa faci te speli pe maini.
https://www.g4media.ro/cazuri-de-hepati ... -tari.html

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Re: Hep C

Postby MumaPadurii » Tue Apr 19, 2022 2:03 pm

Ar fi trebuit sa-i sfatuiasca si sa nu faca sex fara prezervativ cu copiii sub 10 ani.
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Re: Hep C

Postby pc7 » Tue Apr 19, 2022 3:31 pm

1. Hep A parca era denumita boala mainilor murdare, deci face sens sa i puna sa se spele pe maini.

2. Voi radeti dar spalatul pe mani nu se face corect nici macar dupa 2 ani de pandemie. Unii cred ca daca ti bagi 2 degete sub apa, gata te ai spalat!
De profesie observator.

"mania grandorii daca n-o ai, la medicina ce cauta n-ai " vlad s.
"latra-ti dusmanii, ca se zapacesc la cap" muma p

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Re: Hep C

Postby alimori » Tue Apr 19, 2022 5:20 pm

ma, io nu rad. am vazut prin baruri iesind de la baie si nici macar nu bagau 2 degete in apa, cum zici tu.
deci avem cazuri si in danemarca si in olanda, dragut. zic sa ne mutam la topicul de preppi si sa ne numaram conservele.
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Re: Hep C

Postby MumaPadurii » Tue Apr 19, 2022 5:34 pm

Macar de data asta nu se mai golesc degeaba rafturile de hartie igienica.
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Re: Hep C

Postby andy gavrilescu » Tue Apr 26, 2022 11:23 am

https://www.facebook.com/photo/?fbid=51 ... 2523715619

s-a gasit cauza, bai frate. lockdownu e de vina, tutu-l in gura sa-l tut :shock:
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Re: Hep C

Postby pc7 » Tue Apr 26, 2022 12:30 pm

Am citit si eu de lockdown, however...in timp ce adultii au lucrat de acasa, gradinitele au fost inchise vreo 3 luni in primul lockdown si inca vreo 2-3 urmatorul an Ianuarie- martie. Deci copii n au fost expusi la whatever in 2020 Martie-iunie si 2021 ianuarie-martie. Nu stiu, nu s expert dar parca nu cred ca asta e cauza.
De profesie observator.

"mania grandorii daca n-o ai, la medicina ce cauta n-ai " vlad s.
"latra-ti dusmanii, ca se zapacesc la cap" muma p

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Re: Hep C

Postby andy gavrilescu » Tue Apr 26, 2022 1:57 pm

Pai asta e vehiculata de antivaxeri, anti-masca, anti lockdown. Si acasa cred ca se expun copiii la aceiasi germeni ca si la gradinita, gen baga mainile in wc si mananca de pe jos.
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De profesie optometrist
*nu exista lentile antiaburire!!!

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jomil
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Re: Hep C

Postby jomil » Tue Apr 26, 2022 3:19 pm

Aici explica mai in detaliu de ce lockdownul ar putea sa fie o cauza a numarului mai mare de cazuri de hepatita data de adenovirus la copii.

https://www.bbc.com/news/health-61220518

Another possible explanation is that restrictions imposed in the pandemic may have led to young children being first exposed to adenovirus at a slightly later point in their lives, leading to a "more vigorous" immune response in some.
Prof Calum Semple, who is an expert in infectious diseases at Liverpool University, said: "Adenovirus virtually disappeared during the Covid outbreak when there was reduced mixing and it has come back in a surge now."
A friend told me i was delusional. I almost fell off my unicorn.

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Melania
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Re: Hep C

Postby Melania » Tue Apr 26, 2022 3:23 pm

Eu am incredere in cercetatorii britanici.
Prof Calum poate pune bazele unui grup; deocamdata e singur.


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