1 / 5

Adverse Event Management

Adverse Event Management. Short Cases. Case 1. 68 yo WF with HCV geno-1b cirrhosis, prior partial non-responder to PEG/RBV stopped after 24 weeks with HCV still detectable. Required both PEG and RBV dose reductions. PMH Psoriasis treated topically w/ good control

felcia
Download Presentation

Adverse Event Management

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Adverse Event Management Short Cases

  2. Case 1 • 68 yo WF with HCV geno-1b cirrhosis, prior partial non-responder to PEG/RBV stopped after 24 weeks with HCV still detectable. Required both PEG and RBV dose reductions. • PMH • Psoriasis treated topically w/ good control • Mild depression – not treated • No cardiovascular disease; otherwise healthy • Exam: • 5’2”, 62kg, • Spleen tip; psoriatic patches on elbows (mod)

  3. Case 1 • LABS • AST 78, ALT 45, AP 123, TB 1.2, INR 1.0, Alb 3.7 • WBC 3.2K, Hgb 11.7, Plts 121K • U/S: cirrhotic appearance, no mass. (AFP 22) • HCV RNA: 765,000 IU/mL • Treatment: • Boceprevir 800 mg TID w/ PEG + 1000 mg RBV • Week 2: WBC 2.8K, Hgb 9.8, Plts 100K (RBV to 600) • Week 4: WBC 2.6K, Hgb 8.9, Plts 96K (marked fatigue) • What to do?

  4. Case 1 • Course: • RBV reduced to 400 mg and Procrit 40,000 ordered • Week 4 HCV RNA: 57,000 IU/mL • Boceprevir initiation delayed 2 weeks • Hgb increased to 10.8; RBV increased to 600 mg • Boceprevir started at week 6 • Week 8: WBC 1.9, Hgb 9.4, Plts 86K • Week 10: WBC 1.7, Hgb 8.9, Plts 78K; PEG reduced 135; RBV reduced to 400 mg; HCV RNA: <43 IU/mL • VERY fatigued, SOB, more depressed….continue???

  5. Case 1 • Course: • Week 12: WBC 2.1, Hgb 8.7, Plts 81K; • HCV RNA: undetectable • Patient decides to quit therapy…”never felt so bad!”

More Related