Phlebotomy Improves Hepatitis C
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From: ironjustice on 18 Apr 2008 13:36 Bloodletting in hepatitis .. Whoda .. thunk. Dig Dis Sci. 2008 Mar;53(3):815-22. Epub 2007 Sep 12. Phlebotomy improves therapeutic response to interferon in patients with chronic hepatitis C: a meta-analysis of six prospective randomized controlled trials. Desai TK, Jamil LH, Balasubramaniam M, Koff R, Bonkovsky HL. William Beaumont Hospital, Royal Oak, MI, USA. tusarde...(a)aol.com Prospective randomized controlled trials (RCTs) comparing phlebotomy and interferon (IFN) treatment to IFN alone in patients with chronic hepatitis C (CHC) have suggested a benefit for the phlebotomy group. However, statistical significance was achieved in only one of these trials. We performed a meta-analysis of RCTs comparing phlebotomy and IFN to IFN alone for the treatment of CHC. The MEDLINE database and Cochrane registry of controlled trials were searched using the key words "phlebotomy" and "treatment of hepatitis C." Reference lists of review articles discussing the interaction between iron and CHC, and prospective RCTs comparing phlebotomy plus IFN therapy to IFN alone were searched to identify additional RCTs that compared phlebotomy plus IFN to IFN alone. Peto odds ratios with their 95% confidence intervals and Forrest plots were generated for each variable to assess the relationships among the studies that had provided that information. Statistical analysis was performed using Comprehensive META-Analysis version 2.0. Six prospective RCTs were identified: all used sustained viral response (SVR) as an endpoint. The three largest RCTs excluded patients with cirrhosis. Two RCTs specifically included only patients with either high ferritin or high hepatic iron content. IFN treatment regimes varied. Length of treatment varied between 6 and 12 months. The phlebotomy plus IFN group and the IFN group did not differ with respect to the percentage of patients with cirrhosis or genotype 1. SVR was attained in 50/182 (27%) patients in the phlebotomy plus IFN group, compared to 22/185 (12%) patients in the IFN group. Peto odds ratio for SVR in phlebotomy plus IFN group was 2.7; 95% CI 1.6-4.5, P < 0.0001. All five RCTs published in manuscript form showed a trend towards a benefit from the phlebotomy plus IFN in attaining SVR, and the results of the meta-analysis were not dependent on any single RCT, since excluding any single RCT did not change the results. Phlebotomy improves the SVR in response to IFN treatment in patients with CHC. Confirmation of this will require RCT with detailed pre-treatment iron studies and appropriately powered to demonstrate a statistically significant benefit. PMID: 17846887 [PubMed - in process] Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk
From: Fee Fi on 19 Apr 2008 09:16 ironjustice(a)aol.com used his keyboard to write : > Bloodletting in hepatitis .. > Whoda .. thunk. > > Dig Dis Sci. 2008 Mar;53(3):815-22. Epub 2007 Sep 12. > Phlebotomy improves therapeutic response to interferon in patients > with chronic hepatitis C: a meta-analysis of six prospective > randomized controlled trials. > Desai TK, Jamil LH, Balasubramaniam M, Koff R, Bonkovsky HL. > William Beaumont Hospital, Royal Oak, MI, USA. tusarde...(a)aol.com > > Prospective randomized controlled trials (RCTs) comparing phlebotomy > and interferon (IFN) treatment to IFN alone in > patients with chronic hepatitis C (CHC) have suggested a > benefit for the phlebotomy group. > However, statistical significance was achieved in only one of these > trials. >... People need to be very careful about this. Might help people who have iron overload (primarily men) reduce their iron, which would make sense since iron overload has been shown to reduce SVR and make liver disease worse. Not so clear if someone is iron deficient (particularly common in women), since phlebotomy (removing blood) would make that worse, then anemia is worse, and that would make the side effects from riba worse (requiring a drop in riba dose). Since higher doses of riba are needed for best SVR chances, phlebotomy might be a really bad idea in people who are borderline or low on iron. -- Fee Fi
From: ironjustice on 19 Apr 2008 10:08 On Apr 19, 6:16 am, Fee Fi <hopNO...(a)ScomPcastA.Mnet> wrote: phlebotomy might be a really bad idea in people who are borderline or low on iron << Really bad idea .. That covers alot from .. cysts to death .. Maybe you should narrow this "really bad idea" .. down .. ? Especially it seems when people consider the treatment to be 85% recovery WITHOUT your .. precious .. "riba" .. "I won't be able to do my .. riba" .. In case you don't understand what I just said .. Phlebotomy REPLACES .. riba .. Don't NEED the riba .. Forgo the .. riba .. Won't need the .. riba .. Understand .. ? "effective cure rate in the area of 75-80%" http://www.myanmar.gov.mm/Article/Article2004/July/july31.html Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > > > > > > > Bloodletting in hepatitis .. > > Whoda .. thunk. > > > Dig Dis Sci. 2008 Mar;53(3):815-22. Epub 2007 Sep 12. > > Phlebotomy improves therapeutic response to interferon in patients > > with chronic hepatitis C: a meta-analysis of six prospective > > randomized controlled trials. > > Desai TK, Jamil LH, Balasubramaniam M, Koff R, Bonkovsky HL. > > William Beaumont Hospital, Royal Oak, MI, USA. tusarde...(a)aol.com > > > Prospective randomized controlled trials (RCTs) comparing phlebotomy > > and interferon (IFN) treatment to IFN alone in > > patients with chronic hepatitis C (CHC) have suggested a > > benefit for the phlebotomy group. > > However, statistical significance was achieved in only one of these > > trials. > >... > > People need to be very careful about this. Might help people who have > iron overload (primarily men) reduce their iron, which would make sense > since iron overload has been shown to reduce SVR and make liver disease > worse. > > Not so clear if someone is iron deficient (particularly common in > women), since phlebotomy (removing blood) would make that worse, then > anemia is worse, and that would make the side effects from riba worse > (requiring a drop in riba dose). > > Since higher doses of riba are needed for best SVR chances, phlebotomy > might be a really bad idea in people who are borderline or low on iron. > > -- Fee Fi- Hide quoted text - > > - Show quoted text -
From: greyhackles on 19 Apr 2008 11:57 On Sat, 19 Apr 2008 07:08:40 -0700 (PDT), "ironjustice(a)aol.com" <ironjustice(a)aol.com> wrote: [...] >Understand .. ? "effective cure rate in the area of 75-80%" Hmmm....a four year old speculative statement... Much more recently, *someone* posted this result of retrospective analysis: "SVR was attained in 50/182 (27%) patients in the phlebotomy plus IFN group" Seems like *someone* is confused about speculation verses actual facts... /greyhackles
From: tom on 19 Apr 2008 12:19
"greyhackles" <greyhackles(a)REMOVEyahoo.com> wrote in message news:tb5k04t7g0lpeoqrve4qtso5oe1hkn4t2e(a)4ax.com... > On Sat, 19 Apr 2008 07:08:40 -0700 (PDT), "ironjustice(a)aol.com" > <ironjustice(a)aol.com> wrote: > [...] > >Understand .. ? "effective cure rate in the area of 75-80%" > > Hmmm....a four year old speculative statement... > > Much more recently, *someone* posted this result of retrospective analysis: > > "SVR was attained in 50/182 (27%) patients in the phlebotomy plus IFN > group" > > Seems like *someone* is confused about speculation verses actual facts... > > /greyhackles I'm not taking sides on this issue and am only stating MY personal experience. I received phlebotomy's about every 2 weeks through most of my 11 months of tx as a result of elevated Ferritin levels. It was suspected I suffered from Hemachromotosis before tx. I suffered from severe Anemia during tx but my Hematologist felt my high Ferritin levels were a greater risk that the anemia. I'm 2 1/2 years post tx now and am still enjoying SVR and have sustained a normal Ferritin level since completing tx requiring no phlebotomy's. |