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Saturday, October 1, 2016

Gvt Health body torpedoes Genvoya(tm)

Gvt Health body torpedoes Genvoya(tm)
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.

From a patient who has poorly maneuvered:

What a journey! You toasted almost all your treatment options simply because of toxicity that you, and you alone, allowed to break in... Bravo!

Apart from the initial phase, your new combo has a very low dropout rate. This one remains widely used, to the chagrin of merchands. The Genvoya ® proposal will then have no interest.


If the patient has a proactive doctor: the 'promise' for relief that was made to encourage the patient to enter early in treatment, will be held. If the doctor is of the reactive type (relief only if under duress) the promise of yesterday will quickly retracted.
Remember to ask about what happens next before running to the slippery slope

In the first few years of its release, no one had seen the toxicity caused by TDF (which is in Truvada®). No one. No one; neither phase 3 trials or systematic monitoring done by D: A: D: S. And this, everyone has forgotten.

Toast an option due to resistance or due to toxicity, it is the same shit!

If the doctor is seasoned and proactive; the 'promise' of a lower medication burden that entices the patient to early treatment, will be fulfilled. If the doctor is of reactive type (lesser medication load only if under pressure) the promise of yesterday will quickly be retracted.

You want to take a second opinion (in a perspective a lower burden): you are proactive.

And, if you go to a reactive doctor, same as your current doctor, you are fooled again. And you can not know in advance: doctors not to put their 'profile' under their name

HAS torpedoes Genvoya®


Translation Note: the HAS (Haute Autorité de Santé) is a French gvt body, established in the wake of the Vioxx and mediator scandals; An equivalent to Britain's NICE. It aims at protecting patients and doctors again falatious claims.

The HAS ruling concerning Stribild® was already severe: it had positioned Stribild® in second line.

It points: [...] the low genetic barrier to resistance to elvitegravir and the lack of demonstration superiority in terms of effectiveness compared to other available INI (Dolutegravir, Raltegravir), and the need for a pharmacokinetic enhancer, Cobicistat, [...]

Genvoya® is nothing but Stribild® where TDF was substituted by TAF. Here is piece in Pharmaceutical that introduces the trick: This is an incremental innovation, which the Transparency Commission of the HAS has also denounced no improvement in actual benefit (although benefit is important)

The 2 reference documents are:

TRANSPARENCY COMMITTEE, Avis and March 2, 2016 and SUMMARY OF OPINION OF THE TRANSPARENCY COMMITTEE; General access is here.

About Genvoya®, it says: When a treatment strategy with integrase inhibitor is considered, Genvoya ® is a second-line treatment option.

In short: Say, you are under Atripla ®, and your doctor offers Genvoya®. If you want to follow the opinion of the HAS (or simply if you want to avoid Genvoya® food obligation): simply show this ruling to the doctor. Does s/he considers a treatment strategy with integrase inhibitor? Obviously, yes. Can s/he suggest Genvoya®? Well no ! It should first try the alternatives: Raltegravir (Isentress ®) or Dolutegravir (in Triumeq® or Tivicay ® ®)

If we follow the HAS (May 2016), Genvoya ® should only be considered as a replacement to Stribild® or Isentress ® . HAS denies the use of Genvoya® outside this context of historical continuity.

If you go by the HAS, Genvoya ® should never be your first treatment, or even, in the vast majority of cases, your second. At the earliest, this will be your third ...

For a relegation, that is a relegation! ...

And that nobody talks about ...

HAS: schizophrenic and obsequious


Having thus torpedoed Genvoya®, HAS will engage in an exercise of unprecedented baseness.
So, it had just disqualified for lack of improvement (TAF weak evidence of toxicity reduction), but, in the same document, it pleads the manufacturer to promptly substitute TDF by TAF, in other products . It has nothing to do with Genvoya®, but they write it there, in the ruling on Genvoya ®: message well received or a shot in the dark?

France, now a pharmaceutical dwarf, forced to supplication.

As if the US were to return a favor as they just sunk their flagship to the sea floor!

Genvoya ® HAS got it right: the trap is set for you


HAS saw it coming: in a future post, I 'll report how a Quebec doctor screwed a patient. For him, the pill is bitter: if he had read us, he would have thought twice.
This case illustrates a scandal being put in place: it is the same order of magnitude as the tainted blood scandal: the problem is known, but the alarm is not sounded.

By definition, the trap is concealed: it is enough to reveal the mechanism for curdling terror. To be continued...

Comical: the Seroneg's coming-out



Seronegative explain life to poz, as read on the Web, and worth reflecting upon:
Weird story about the 'AIDS' organizations: An official at a local 'conference' (AIDES) talks to about twenty HIVers on how to approach life ... I ask him if he is HIV positive, to what he replied that he preferred to keep the answer for himself! ... I left the room, protesting that announcing one's HIV status could be a problem that adds to the one of announcing one's HIV negative status!


Have a good week-end and good fuck!


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.

4 comments:

  1. AnonymousJuly 21, 2017

    Quick Hello from F... from ... (do not publish my email, pls)

    ReplyDelete
  2. Thank you... indeed, we never publish emails addresses

    ReplyDelete
  3. For 22 years, after experiencing a lot of treatments, including the association Isenress / Prezista / Intelence boosted, the kidneys a show great weakness.
    No problem: I am offered Genvoya (tm) + Prezista (tm) 800 (I'm 72). Definitively unbearable, pain in the bones, belly aches are more than severe and total lack of sleep, I dropped immediately: this medication is much more painful than the disease and I will try to resume the old treatment (despite its price!)

    ReplyDelete
    Replies
    1. The boosted Isentress (tm) / Prezista (tm) / Intelence (tm) combination seems to be a combination of the same type as the TRIO trial.
      Your recent change preserves Prezista (tm) which could be, therefore, not the cause ...

      It has the advantage of avoiding NRTIs, including TDF that is noticeably harmful for the kidney.

      It may have been chosen in this perspective. If this is the case, perhaps we can consider NRTIs that are less harmful to the kidney, such as ABC, Videx or the very recent TAF, which is actually found in Genvoya (tm).

      If it was chosen because of multiple resistance (it is a rescue of last resort) it means that the options are limited: you have to consult a super-doctor (here probably Leibowitch):

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

      Can we take advantage of the increased efficiency of second-generation INIs (Dolutegravir or Bictegravir) to replace this Isentress (tm)? I do not know ... It may be interesting to consider the thing.

      A priori, this type of TRI therapy does not make it eligible for type 4/7 short cycle. So it limits the options a lot.

      Can we restore susceptibility to the virus by cleaning up old resistance with the drowning technique (see Leibowitch)? See with him ...

      This example shows how younger people are wrong not to worry about long-term toxicity.

      Indeed, you must take things in your hands! And share the result of your upcoming consultations and decisions. Please testify and to keep us informed!

      Delete

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