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Friday, July 14, 2017

IAS-2017-Paris, ANRS-4D



Summer 2016: we offered a serial: ANRS-4D and the cheaters
Summer 2017: we will debunk DOMONO:
- Dolutegravir and R263K
- R263K: new scenario (DOMONO)
- N155H: new scenario (DOMONO)
- Nevirapine and Mono-DTG Switch: the Hunchback Trap
- calculation error in the primary hypothesis
- DOMONO and the benefit for the patients (not for BigPharma ...)


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

IAS-2017 in Paris, ANRS-4D and 4/7

By Charles-Edouard!

After Durban (2016), Paris hosts the IAS-2017 congress. A trimmed, more scientific edition!

ANRS is a co-organizer. Its only relevant contribution to history was ANRS-4D: the rest is of no interest, others would have done anyway, or appaling fiascos (eg Mobidip or Ipergay, so quickly forgotten). ANRS-4D, as an unfinished version, was presented at DURBAN.

There will be an ANRS-4D poster, announced as: MOPEB0321, ie Monday (MOnday) Poster Exhibit session B; details are not yet available.

It is not very much, but apparently they had to struggled quite a bit to get something!

IAS-2017: alleviation session


There is a session devoted to alleviation:
IAS 2017 ANRS allègements international AIDS society Paris Durban poster ANRS-4D


Professor Katlama will talk about initiations under mono and bitherapies, normal ...
IAS 2017 ANRS allègements international AIDS society Paris Durban session  Turkova Anna Katlama
Dr. Pedro Cahn, bitherapies (father of GARDEL and PADDLE), normal, a Thai doctor of reduction, good, why not ...

For strategies 4/7, there will be ... Discussed by Dr. ... Discussed by Dr. Molina Anna Turkova !!! Paris will discover her. Unknown? She is coordinator and author in the BREATHER trial (5/7), her topic is: Treatment four days a week: for whom is it an suitable option

She may not be aware of ANRS-4D: even the press release has disappeared from ANRS site (see a back-up here)! Has she gained experience on the 4/7 somehow ??? (Or Penta-15?)

The situation in the fields has changed quite rapidly:

In Garches, data are collected from 114 patients (FASEB J, 2010 and 2015): no failure over more than 600 years of treatment in 4/7.

ANRS-162-4D, enrolled 100 patients (see IAS 2016, Durban, manuscript submitted for publication): no failure in eligible patients who adhered strictly to the protocol, ie, zero intrinsic failure.

As of November 2016, French Guidelines, quoting BREATHER and ANRS-4D, authorized the free practice of 4/7, outside of clinical trials.

In addition, 2 patient associations collect clinical data, in parallel and independently, from conventional clinical trials. A list of doctors is available.

Today, patients under treatment 4/7, in France, can be estimated at about 500 ... And counting! Paris follows trendy fashions !

A large, controlled clinical trial, ANRS-170-Quatuor, will soon begin in 62 French university hospitals, with 640 eligible volunteers.

It can be anticipated that this presentation, at IAS-2017 in Paris, will have a significant impact on participants ...

Has she had a chance, at least, to discuss this with investigators involved?

Breather: a good trial, a bad theory


I have echoed BREATHER, here, in details! This is the only place.
Unfortunately, the authors theorize, speculate, wrongly. The weakness of the authors of BREATHER is to theorize around a pharmacokinetic specificity of EFV (whereas the majority of children take AZT, with a short half-life ) There are reservations here, and there, that have been added by castrators, on a very undefendable argument. It is a shame because it deprives hundreds of thousands of children of a salutary strategy. I would like to remind you of a fundamental difference between BREATHER and ICCARRE / ANRS-4D / Quatuor: the lack of prognosis on genotype!

4/7: for whom is this a suitable option?


The question is interesting and falls right to the point: we will listen to the arguments of the restrictive clan, and dissect them! Remember to record the arguments of this session.

It was a tiring week! So, Good Weekend and good fuck!

Comments


Anonymous 15 Aug 2017


Charles-Edouard! 15 Aug 2017




Summer 2016: we offered a serial: ANRS-4D and the cheaters
Summer 2017: we will debunk DOMONO:
- Dolutegravir and R263K
- R263K: new scenario (DOMONO)
- N155H: new scenario (DOMONO)
- Nevirapine and Mono-DTG Switch: the Hunchback Trap
- calculation error in the primary hypothesis
- DOMONO and the benefit for the patients (not for BigPharma ...)


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

2 comments:

  1. Hello,
    I had a VL of 2500 at the beginning of the treatment (genotype = sensitive virus), dropped to <50 copies 3 weeks later, and strictly undetectable since (5 consecutive tests).
    I am under Eviplera and I have a lot of nausea and weight loss + my cheeks are getting worse. I also have prolonged fatigue and have to rest all the time. Alleviation is out of the question for my doctor. The alleviating doctor I consulted told me to wait 18-24 months before trying 4/7. According to him the benefits to start today would have no real impact on my well-being, while the risk of escape would be real.
    How to do? Since there is no objective basis for defining the date from which the risk benefit is balanced.

    ReplyDelete
  2. The Morlat 2016 report (ANRS) allows the short cycle under conditions similar to the trials. Strictly speaking, within ANRS-4D inclusion criteria, 6 months is a bit short.
    It should be noted that these are conditions a priori, based on previous studies done on 'chronic' patients, often under treatment for several years.

    With immediate treatment, the demand for relief earlier becomes more prominent. The Practical Guide addresses the question:

    https://once-weekly-hiv-therapies.blogspot.fr/p/practical-guide-safe-47.html

    You do not say which doctor you saw ...
    I have been told that Dr. Jean Yves LIOTIER is quite willing to use Eviplera (tm); check him out

    https://charles-edouard-ma-liberte.blogspot.fr/p/medecins-allegeurs.html

    Eviplera (tm) was only used in 4D. Its predecessors (Atripla (tm) for example) were used in FOTO. However, FOTO starts from 3 months of undetectability. But is not a direct 4/7.
    Morlat says similar conditions, it does not say identical ... So, while waiting to be in the window of eligibility of ANRS-4D, you can refer, during your interview with the doctor, to FOTO and our Guide

    Your VL was only 2500 before treatment. If you could negotiate a 6/7 and see when you can start it, that would be good.

    The Practical Guide is, like your doctor, a little conservative. But well... an initial VL of 2500 is really very very low ...
    We can wonder if the recommendation to treat early really makes sense in this case. The 'scientific' argument often quoted is the START trial, but were there at least patients with VLs as low ???

    Indeed, there is no scientific abacus that tells you there or when there is a risk of failure, for the simple reason that in Premium mode, there has never been any failure

    Try to find a doctor who looks after you and no protocols on patients who had much higher CVs.
    This blog is not a medical advice.

    ReplyDelete

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