Steve Flamm

Professor of Medicine in the Division of Hepatology at Northwestern University Feinberg School of Medicine; Medical Director of Liver Transplantation

[Steve Flamm @SteveFlamm]

T7; Also, concomitant alcohol use in the setting of HCV is deleterious and should be avoided #ddw15chat

[Steve Flamm @SteveFlamm]

T7; Many companies also have programs to provide therapy for patients that have been denied #ddw15chat

[Steve Flamm @SteveFlamm]

T7; If therapy is denied, another attempt should be made in 6 months or so as the approval process is changing quickly #ddw15chat

[Steve Flamm @SteveFlamm]

T7; Second, there are well tolerated therapies available now that have very high cure rates #ddw15chat

[Steve Flamm @SteveFlamm]

T7; First, HCV is not transmissible by casual contact; so there is little concern for transmission #ddw15chat

[Steve Flamm @SteveFlamm]

T6; Extrahepatic manifestations of HCV are also occasionally observed; cryoglobulinemia, porphyria, lichen planus, etc #ddw15chat

[Steve Flamm @SteveFlamm]

T6; HCV is associated with DM, lymphoma, certain skin disorders, depression, and poor quality of life. Unrelated to cirrhosis #ddw15chat

[Steve Flamm @SteveFlamm]

T6; Aside from complications of cirrhosis and liver related mortality, HCV has been associated with increased ALL cause mortality #ddw15chat

[Steve Flamm @SteveFlamm]

T6; potential complications include issues related to cirrhosis (encephalopathy, varices and ascites). HCC is also common #ddw15chat

[Steve Flamm @SteveFlamm]

T5; I believe the vast majority of pts with HCV should be treated; no other treatable diseases with bad consequences are ignored #ddw15chat

[Steve Flamm @SteveFlamm]

@drmakclinic There is only a place for the old regimen in parts of the world where the new regimen is unavailable #ddw15chat

[Steve Flamm @SteveFlamm]

T5; Younossi showed substantial savings; I suspect more studies will show similar findings all around the world #ddw15chat

[Steve Flamm @SteveFlamm]

T5; Improved morbidity and mortality from eliminating HCV should provide substantial benefit to the economy #ddw15chat

[Steve Flamm @SteveFlamm]

T5; HCV is associated with fatigue, poor quality of life, depression and "brain fog." SVR will hopefully ameliorate these sxs #ddw15chat

[Steve Flamm @SteveFlamm]

T4; Difficulties with access have hindered treatment by Hepatology as roadblocks to therapy are time consuming for office staff. #ddw15chat

[Steve Flamm @SteveFlamm]

@drmakclinic New therapeutic options for GT 4 should be approved within the next 6 months or so. #ddw15chat

[Steve Flamm @SteveFlamm]

T4; And a small number of pts still fail the new therapies; what to do with them? Some challenges remain. #ddw15chat

[Steve Flamm @SteveFlamm]

T4; Pts with GT 3, particularly who have previously failed IFN and who have cirrhosis, do poorly with the new regimens. #ddw15chat

[Steve Flamm @SteveFlamm]

T4; Pts with cirrhosis also have slightly lower response rates and often require longer courses of therapy. #ddw15chat

[Steve Flamm @SteveFlamm]

T4: Some pt populations remain unmet medical needs, including severe kidney disease/dialysis. #ddw15chat