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Saturday, December 5, 2015

Stribild ®, EACS-2015, Hocqueloux


This paper was originally published here, in French. We provide the google translation for your convenience. Proper translation will come soon. Some practical aspects may differ where you live.

Stribild ®, EACS-2015, Hocqueloux

Stribild ®, EACS-2015 Hocqueloux

Here is a comment that leaves me speechless (with Stribild ®, soon Genvoya ®)
I just read on this blog that the monotherapy Tivicay (tm) was not recommended for people being already under Stribild (tm). Under Stribild (tm), I currently oscillates between 3/7 and 4/7 and I have no problem except that renal function is in steady decline since the beginning of treatment there 1½ years , decrease in low but still constant proportions. Stribild (tm) is my first treatment.

The question is a good reply to the frightened souls (and subsidized).

Prudence they say! Sure ... But also prudent to preserve his organs, all his organs. Renal disease can not be overlooked. A kidney is more important than profits.

Tenofovir (included in Stribild ®) is the most likely cause. There are so many options to transfer Tenofovir ... The proposal to replace the difumarate Tenofovir alafénamide by tenofovir (in Genvoya ®) more commercially attractive than therapeutic.

Anyway, we must descend into the valley polluted from 7/7 to properly validate any new strategy. And, as both do, get rid once and for all tenofovir. Basta!

I will return soon on the results of Ch Katlama at EACS-2015. It might (the conditional!) That users (past or present) first generation INI (RAL or EVG) are required to advance in single strategies Tivicay ® therapy with redoubled caution. For others, it's nickel in nickel ...

The manufacturers know the on-medication (ie legal poisoning): They will therefore propose 'copies' of their généricables molecules, at lower dosages, but a greater strain on the patient: obligation meals and observance 7/7 : it maximizes profits while there are proven solutions that relieve the patient at all levels. First generation INI were helpful, thank you ... Let's move on!

Nothing is easier than to be prescribed Tivicay ® + Lamivudine:
Since EACS, it goes like a letter in the mail. And if you do not succeed, take Rdv at: Reynes (Montpellier), Hocqueloux (Orléans), Lafeuillade (Toulon), Katlama (Paris): there are spoiled for choice. Once confirmed undetectable, is simple to continue: we do not change a winning team!

HYPO-DOLU EACS 2015 monotherapy Tivicay dolutegravir cohen Pedro Cahn Paddle
Dr. Pedro Cahn (PADDLE trial), he has the honesty to provide raw data.
Monitoring patients (DTG attack treatment + 3TC, 3TC which serves as decoration ...) allows to put into perspective a little quick affirmation of the manufacturer: the higher the dose is high undetectable soon be reached. The 50 mg dose of the original horse, provides undetectable every time.

It is especially obvious here that the time the virus remains detectable is in proportion to the initial viral load.

Therefore, keep the horse initial dose (50 mg to 22 Euros per day), to life, to hold a lentivirus, confined to his tank, is a question more legitimate.
Treaties: YES, processed and taken for idiots: NO ...

DTG + 3TC is a virtual monotherapy. Farewell resistance implies that DTG is super-efficient and that the dose can be optimized once the infection subsided.
If you come across a clinician who does not understand this, take your legs to your neck, and leave the poisoner in white coats.
Simplification dolutegravir in mono- or dual therapy maintains viral suppression in treatment-experienced patients, Laurent Hocqueloux

HYPO-DOLU EACS 2015 monotherapy Tivicay dolutegravir Laurent Hocqueloux bitherapy

His post at EACS includes such impressive results for 52 patients pretreated using dolutegravir in mono (n = 21) or combination therapy (n = 31).

Here, nine people had prior experience with an integrase inhibitor. median follow-up of 27 (IQR 24-40) and 45 (IQR 25-70) weeks in mono and dual therapies, respectively, all but one participant maintained viral suppression <50 copies / ml (96% of CV < 20 copies / ml). Only one case of viral rebound in a patient, very few observing under dual therapy DTG / Maraviroc.

Note, 2016-10-09 : the complete report is available:
Dolutegravir-based monotherapyor dual therapy maintains a high proportion of viral suppression even in highly experienced HIV-1-infected patients

To repeat: 95% of patients, stable and undetectable, are unnecessary and harmful on-medication!

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