HomeMethodsStatementsThe
Liver
Silvia Hinojosa-Price, RN,
corresponds with Dr. Zobair
Younossi, M.D., M.P.H. Director, Center for Liver Diseases,
Medical Director, Liver Transplant Program, with questions
related to insulin resistance in advanced liver disease, as well
as lower response to antiviral therapy.
Zobair Younossi, MD, MPH Director, Center for Liver Diseases Medical Direcor, Liver Transplant Program Inova Fairfax Hospital Co-Director, Center for the Study of Genomics in Liver Diseases Affiliate Professor of Biomedical Sciences George Mason University Fairfax, Virginia . UPDATE:
It worked! Adding Metformin to Peg-Interferon and Ribavirin,
espically before treating, increased odds for clearing
Hepatitis C. More patients achived a Substaind Viral
Response (SVR) with Metformin.
...123 patients and 22 discontinued because of
non-compliance, stopping before week 24, lost to follow-up,
etc. Of the 101 that finished the study, SVR was 67.4% for
the Metformin group vs 49.1% for the Peg+Riba group...
AND... the study show if a higher dose of Metformin was used
from the start. (study used 425mg three times a day x4 weeks
then increased it to 850mg three times a day) and taken
before treatment... could prompt even better SVR results.
And so....
Insulin Resistance now becomes the new PREDICTOR for SVR
(independent of genotype and fibrosis stage).....finally.
Quote from article below: "Women have more fat stores," Dr.
McCullough explained. "Metformin improves their response,
but at 57.7%, response rates are still low, overall." "Many
patients with chronic HCV infection have insulin
resistance," noted Dr. McCullough. "Fat in the liver
inhibits response to antiviral therapy. Increasing insulin
sensitivity should improve response to treatment."
http://www.docguide.com/news/content.nsf/news/852571020057CCF6852574F60061DC6D Metformin Improves Antiviral Response Rates in Chronic Hepatitis C: Presented at AASLD By Em Brown
SAN FRANCISCO -- November 3, 2008 -- Patients with chronic
hepatitis C virus (HCV) infection who have responded poorly
to standard antiviral treatment in the past may get a bump
in viral response rates if the antidiabetic agent and
insulin sensitiser metformin is added to pegylated
interferon (PEG-IFN) alfa-2a and ribavirin, according to
findings presented at the Liver Meeting 2008, the 59th
Annual Meeting of the American Association for the Study of
Liver Diseases (AASLD).
Do You Have Insulin Resistance? Increase Interferon treatment odds at a "Sustained Viral Response" (SVR-clearing the virus! )
Note to all: Most doctors are not aware the roll IR plays or
how to compute HOMA. Check his work, and take this info with
you when seeking advice.
HOMA is a formula that uses the results of 2 blood
tests ....a FASTING INSULIN and FASTING GLUCOSE
(sugar) to figure out if you're insulin resistant.
(Fasting Insulin X Fasting Glucose, Divided by 22.5)
A HOMA result of < 2 is considered NORMAL.
In genotype 1, studies have shown that the more insulin resistant you are, the lower the SVR....
HOMA < 2 SVR 60.5%
HOMA between 2-4 SVR 40% HOMA > 4 SVR 20% MUST READ! |
