Another Comparison of PEG to Besremi

[EPguy]

I had this in a reply thread, figured it's worth its own. This recent report shows PEG and Bes are not the same in the context of Hep C.

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No way to say whether it's relevant to us, esp since Hep C treatment adds oral ribavirin, and it's a small trial. But it seems to show the two are good for Hep C but not fully equivalent. PEG was more effective for HepC treatment at 96% response while Bes average (over three different dosings) was 74%.

It is a surprise to me. Esp since the report is from Taiwan, where Bes is made. Their conclusion does suggest a bias since it states the two INFs are "as effective" but the numbers suggest otherwise.

They tested one dose size for PEG while 3 for Bes, also suggesting a bias to favor Bes.

I've noted elsewhere that the two INFs use a different INF type, α-2a vs α-2b. Still curious if it matters.

One item of interest is the higher doses of Bes (270, 360, 450mcg) actually tended to decrease response. We are finding on the Voice that the published high doses of Bes for MPN may be more than we need.

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We're also finding different reported responses between these INF types on the forum, with one or the other being better tolerated. So I think there is increasing evidence the two are not entirely equivalent.

sciencedirect.com/science/a...

[hunter5582]

I think is simply makes sense that the two different formulations are different. How they are different? time will tell.

[EPguy in reply to hunter5582]

This difference may be useful for us in that if one INF is not working out well the other one might, as we've seen already. I like knowing there are two ways to have INF.

[Manouche]

Hi EPguy,Thanks for sharing this interesting paper. Unfortunately, « There was a major limitation in this study. The small sample size in each group may not have adequate statistical power to detect the difference in efficacy and safety across groups ». So no solid conclusion can be drawn from this work.

[EPguy in reply to Manouche]

I agree the sample is small as I noted, esp for the number sub groups they used. So many of the MPN reports we see have small n, it is unfortunate.

I've also posted on a study that incidentally found diffs between Intron and Pegasys, (PEG was better) with the same small n limitation.

Interesting to me is this idea in context of some members here reporting better results or tolerance on one or the other, but also very small n. My take is if one type of INF is giving tolerance trouble it could be good to ask Dr about trying the other one. After last week I have been thinking about this very idea. (But I do plan for now to continue with Bes)

[monarch5000]

On other forums, I've already seen two examples where patients who experienced intolerable or unpleasant side effects from Besremi were not offered the opportunity to try Pegasys. Their doctors wrongly assumed these patients were intolerant to all interferon alfa formulations, hence they advised them to try other drugs like Jakafi.

[EPguy in reply to monarch5000]

That's not right that the patient can't get the care they seek. I think the best data we've got for this case is on these forums. You've said you know of several such patients including your self that might or have benefited from PEG over Bes, is that right?

I'm not too bad so far from my Bes dose last Wed. Next few days will give me a better idea.