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Re: Prednisone???

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Hi Joan,

I am sorry you are facing this complex question, and I don't think there is an

easy answer. When you next talk to your pulmonologist, ask her first her

thoughts about Pirfenidone. If we set our sights too high on this one, we may

find ourselves opting out of the treatments that show the most promise, albeit

very little in most cases.

Pirfenidone has not shown itself to be effective in stopping pulmonary fibrosis.

In studies just completed, the pulmonary function level still trended downward

in patients taking perfenidone. Only a slight slowing was evident, and that

mainly in the first half of the trials. Also, those on pirfenidone showed only a

slight decline in death rate from 7.1% to 3.5% during a 72 week period.

Intermune will push strongly for us and our pulmonologists to use Pirfenidone,

but it is my hope that it will not be at the risk of foregoing treatments that

may individually have more promise.

As you certainly are, as I read your post, we need to be savvy and knowledgeable

about our particular situations. I certainly understand your reluctance to take

prednasone, and could understand whatever you decide. If your pulmonologist had

not said that the dose would be reduced after the initial dose, I would have

advised against it. But if your pulmonologist can live with the idea that you

can accept only a very low dose after the reduction, then I would advise you to

try it, especially considering your lower numbers. You might even suggest

starting at 40 Mg instead of 60. It will rest with you, but I would not advise

any one to look past what is available, hoping that Pirfenidone will stop the

regression. I really don't want Intermune to prey on uneducated patients looking

for hope. We need to keep hope that we will have better treatment options very

soon.

Jerry/Muississippi/54/IPF/dx April 05

>

> Hi All -

>

> I saw a new Pulmo-dudette ? last week and as I'm continuing to degrade and my

O2 keeps dropping, she wanted to put me on prednisone 60mg/day for 1 mo. and

then reduce it. 

>

> However, I have a plethora of maladies...and am concerned about problems

taking it.  I read about pirfenidone (I think), but it's not approved for use

here in the US, yet.

>

> I don't think I'll take the pill tomorrow and will call the dr. first thing

Monday AM.  Ideas, suggestions, experiences as nearly every maladie is

contraindicated for me and I already walk a narrow line keeping everything in

balance and where the drs. are happy???

>

>

> Joan M, in N. Calif.

> Diab2 96, GERD 96, CAD 97, Glaucoma 04, CKD3 05, Osteoporosis 08, PF 08

> " life is not about waiting for the storm to pass....it's about learning to

dance in the rain "

>

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Joan

Unfortunately the choices aren't great. Now, you can do everything

possible for all conditions other than your PF. Then as to the PF the

only real choices are pretty powerful drugs or nothing. Prednisone is

the typical choice but depending on your form of PF has various

probabilities of benefit. Sometimes Imuran is used without it or other

immunosuppressants such as Cellcept may be.

The only other thought I toss out is to be certain you've been checked

for PH as it can bring fast decline and there are treatments for it, if

its the problem.

As to Pirfenidone it has not been approved, the trials were not

positive, and it wasn't even tested for anyone other than very early

stage.

I'm sorry I don't have better answers but you need to make your

decisions and choices based on the realities. Were you on prednisone

previously as it seems like you already have what are so many of the

common side effects of it?

>

> Hi All -

>

> I saw a new Pulmo-dudette ? last week and as I'm continuing to degrade

and my O2 keeps dropping, she wanted to put me on prednisone 60mg/day

for 1 mo. and then reduce it.

>

> However, I have a plethora of maladies...and am concerned about

problems taking it. I read about pirfenidone (I think), but it's not

approved for use here in the US, yet.

>

> I don't think I'll take the pill tomorrow and will call the dr. first

thing Monday AM. Ideas, suggestions, experiences as nearly every

maladie is contraindicated for me and I already walk a narrow line

keeping everything in balance and where the drs. are happy???

>

>

> Joan M, in N. Calif.

> Diab2 96, GERD 96, CAD 97, Glaucoma 04, CKD3 05, Osteoporosis 08, PF

08

> " life is not about waiting for the storm to pass....it's about

learning to dance in the rain "

>

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