Dr. Melissa Palmer is the Clinical Professor of Medicine and Director of Hepatology for NYU Hepatology Associates in Plainview, NY. Being an advocate for liver disease research throughout her career, she states: "the advances made in the prevention and treatment of liver disease have been truly remarkable, yet the field of hepatology receives scant attention from the media and little financial support compared with other disease states." As emphasized by the recent Institute of Medicine report, the burden of viral hepatitis in the US continues to grow. Dr Palmer notes that "the efforts of AASLD in support of the passage of bill HR 3974 [Viral Hepatitis and Liver Cancer Control and Prevention Act of 2009> are to be applauded. Without increased funding of programs aimed at prevention, early diagnosis, and aggressive treatment of liver disease, the increasing morbidity and mortality due to liver disease is predicted to become overwhelming."
It is because of her desire to bring liver disease research to the forefront that she was asked to serve on the AASLD's Development Committee. Dr. Palmer began asking her patients enrolled in clinical trials to donate their stipends to The Liver Research Fund to support AASLD's research awards, educational grants, and programs. She asked AASLD to create information that could be distributed to her patients once she realized that many of her patients were willing to donate, but that they needed information on where and how to do so.
AASLD created a flyer stand, flyers, and postage-paid reply envelopes for display in offices, and these items have made it easier for Dr. Palmer's patients to donate to The Liver Research Fund.
Since Dr. Palmer started asking her patients for donations, they have given more than $9000 to The Liver Research Fund. "I hope this will spur enthusiasm among my peers to help raise funds for AASLD. Promoting The Liver Research Fund through my office is a component of my personal commitment to quality liver care," she enthuses.
Members of AASLD can request the fundraising stand, flyers, and information by contacting Heidi Bruce, Director of Development, by email to firstname.lastname@example.org or by phone at (703) 299-9766.
Please click here to read the entire interview with Dr. Palmer.
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If you have a fatty liver ( NAFLD/NASH) and no other coexisting liver disease and live in or near the NY area, I am running a clinical trial of a pill for NASH. Please call 516 939 2626 for details.View Thread
Adherence to pegylated interferon (PIFN) plus ribavirin (RBV), especially in the first 12 weeks, affects sustained virologic response (SVR) in patients with chronic hepatitis C virus (HCV). RibaPak® (RBP) requires fewer tablets than RBV. Aim: To determine if simplifying the dosing regimen of RBV impacts outcomes. Methods: Ninety-two patients on RBP >12 weeks were categorized as follows: Group A (n = 22): treatment experienced with IFN/PIFN and RBV, Group B (n = 49): treatment naïve switched to RBP after >12 weeks RBV, Group C (n = 21): treatment naïve on RBP. Outcomes were compared between RBP and RBV in Groups A and B. Group C was compared to Group D—a matched control group of RBV-treated patients. Results: Patients preferred RBP. RBP was associated with improved patient compliance, less side effects, improved quality of life and a trend toward improved SVR. Conclusions: RibaPak offers an attractive alternative to RBV.RibaPak blister packs offer an attractive alternative to traditional RBV bottled pills. Patients prefer RibaPak compared to RBV due to decreased number of pills, convenience of the blister pack administration, diminished side effects (primarily GI) and improved quality of life. RibaPak is associated with improved patient compliance compared to RBV. This has the potential to avoid wasted drug costs and reduce future comorbidity that is associated with significant health care expense. As the future of HCV treatment will likely involve the addition of a third drug (such as a polymerase or protease inhibitor), simplification of the treatment regimen by a reduction in the number of pills may be crucial to treatment success.View Thread
Alinia has been used successfully in patients with HCV genotype 4 when predosed prior to starting Peginterferon and ribavirin. Among the 96 treatment-naive patients, the SVR rate was 79% in the triple therapy arm, compared with 61% in the nitazoxanide-pegylated interferon dual therapy arm, and 50% in the standard-of-care arm (P = 0.023).
•Among the 24 treatment-experienced patients, the SVR rate was 25% in the triple therapy arm compared with 8% in the nitazoxanide-pegylated interferon arm.
•RVR, EVR, and ETR rates are shown in the table below (see next study description).
•Adverse events were generally similar across all 3 treatment arms.
•The exception was that the rate of anemia was significantly lower in the group that did not receive ribavirin.View Thread
Maximizing sustained virologic response (SVR) rates (an undetectable HCV RNA level 24 weeks after discontinuation of therapy) is the primary goal of therapy for patients with hepatitis C virus (HCV). This endpoint depends on numerous factors (Table), and adherence to therapy is one of the few variables that can be influenced by the patient and/or the healthcare team by using a multidisciplinary approach. Despite the known importance of treatment adherence in achieving viral eradication, adherence continues to be suboptimal, a fact underscored in a recent study demonstrating that only approximately 60% of patients with HCV in the United States adhered to prescribed therapy.[1> The dawn of a new era of HCV treatment is upon us with the anticipated approval of 2 novel direct-acting antivirals (DAAs) in the latter half of 2011. The addition of a DAA to the current standard of care regimen (peginterferon and ribavirin) enhances SVR rates and diminishes length of treatment in many patients.[2-5> However, issues of adherence will likely become even more significant, as the incidence of adverse events may rise, dosing schedules will become more complex, dietary requirements may be needed, and pill burden will increase. Furthermore, the lack of adherence to DAAs may select for HCV drug resistance mutations, a potentially serious consequence not present with the current standard of care regimen. Table. Factors Affecting SVR Rates View Thread