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What Causes High MELD Score While On Sovaldi?
Question: My brother-inlaw is on a trial wiht the new Sovaldi and the other drug. He has been dignosed wiht Hep. C and liver disease- cirrhosis. Everyhting seems to be going finr. My only question concerns his Meld score. It has increased from 8 to 11 or 12 since the start of the clinical trial. The head nurse told my sister this is due to the drug only and not to be concerned. Otherwise, everyhting seems to be working. Is the increase in the Meld score of concern?
XXXXXXX E. Cohen- YYYY@YYYY .
XXXXXXX E. Cohen- YYYY@YYYY .
Brief Answer:
Normal reaction while liver is cirrhotic...
Detailed Answer:
Hi,
I am sorry for the situation of your brother in law. May God alleviate his sufferings and situation.
1. Sovaldi (sofosbuvir) is a novel antiviral medication used to treat patients with Hep.C
As for any other medication, its use is associated with side effects.
2. Liver is the station where all the drugs will travel and gone metabolized to clear off the body.
3. The liver of your brother in law is cirrhotic due to hep.C. Therefore, it will be much more difficult for the liver to clear off the body of this medication.
4. MELD score is estimating the probability of survival with patients with end-stage liver disease (as your brother in law) based on certain variables:
- INR
- bilirubin level
- cretinine level
- and how well his kidneys are working and if he had gone through dialysis?
Although an overall MELD score will be concluded as high, the judgement over Sovaldi side effects is based on evaluation of these parameters separately. You can send a copy of his lab reports for further evaluations.
5. If the head nurse told it is due to the drug, then, this means that his doctor is aware of these changes. Discuss further with his doctor if he needs to reduce the dosage of Sovaldi.
Hope it answered to your queries and put your mind at ease!
Dr.Albana
Normal reaction while liver is cirrhotic...
Detailed Answer:
Hi,
I am sorry for the situation of your brother in law. May God alleviate his sufferings and situation.
1. Sovaldi (sofosbuvir) is a novel antiviral medication used to treat patients with Hep.C
As for any other medication, its use is associated with side effects.
2. Liver is the station where all the drugs will travel and gone metabolized to clear off the body.
3. The liver of your brother in law is cirrhotic due to hep.C. Therefore, it will be much more difficult for the liver to clear off the body of this medication.
4. MELD score is estimating the probability of survival with patients with end-stage liver disease (as your brother in law) based on certain variables:
- INR
- bilirubin level
- cretinine level
- and how well his kidneys are working and if he had gone through dialysis?
Although an overall MELD score will be concluded as high, the judgement over Sovaldi side effects is based on evaluation of these parameters separately. You can send a copy of his lab reports for further evaluations.
5. If the head nurse told it is due to the drug, then, this means that his doctor is aware of these changes. Discuss further with his doctor if he needs to reduce the dosage of Sovaldi.
Hope it answered to your queries and put your mind at ease!
Dr.Albana
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I think I understand it. But the nurse told my sister not to worry about the increase in the Meld score because it is due to the Sovaldi. It seems that you are suggesting that the Meld score is still important. My sister got the impression there is nothing to worry about.
I thought Sovaldi, in combo with the other new drug, is designed to prevent further damage to the liver from Hep C. The nurse told her the drug is working. Are you suggesting it is working too well? My sister mentioned somehting about the bilirubin, but I forget what it was.
Could you please clarify further? I think I understand it. But the nurse told my sister not to worry about the increase in the Meld score because it is due to the Sovaldi. It seems that you are suggesting that the Meld score is still important. My sister got the impression there is nothing to worry about. I thought Sovaldi, in combo with the other new drug, is designed to prevent further damage to the liver from Hep C. The nurse told her the drug is working. Are you suggesting it is working too well? My sister mentioned somehting about the bilirubin, but I forget what it was. Could you please clarify further?
Asked by Me , 1 hour ago
I thought Sovaldi, in combo with the other new drug, is designed to prevent further damage to the liver from Hep C. The nurse told her the drug is working. Are you suggesting it is working too well? My sister mentioned somehting about the bilirubin, but I forget what it was.
Could you please clarify further? I think I understand it. But the nurse told my sister not to worry about the increase in the Meld score because it is due to the Sovaldi. It seems that you are suggesting that the Meld score is still important. My sister got the impression there is nothing to worry about. I thought Sovaldi, in combo with the other new drug, is designed to prevent further damage to the liver from Hep C. The nurse told her the drug is working. Are you suggesting it is working too well? My sister mentioned somehting about the bilirubin, but I forget what it was. Could you please clarify further?
Asked by Me , 1 hour ago
Brief Answer:
Following clarifications....
Detailed Answer:
Hi back,
Thank you very much for your follow up query.
Now, as I have already discussed it earlier, the Meld Score is based on evaluation of certain parameters, including bilirubin level as following:
- INR
- bilirubin level
- cretinine level
- and how well his kidneys are working and if he had gone through dialysis?
So, if the overall MELD score is high, we usually look at specific parameters that are directly related to the liver such as bilirubin level (BL). If BL and INR are improving, we say Sovaldi is working successfully.
Meanwhile, we also monitor the kidney function to observe if any changes occur.
Let me know if you need further clarifications!
Thank you!
Dr.Albana
Following clarifications....
Detailed Answer:
Hi back,
Thank you very much for your follow up query.
Now, as I have already discussed it earlier, the Meld Score is based on evaluation of certain parameters, including bilirubin level as following:
- INR
- bilirubin level
- cretinine level
- and how well his kidneys are working and if he had gone through dialysis?
So, if the overall MELD score is high, we usually look at specific parameters that are directly related to the liver such as bilirubin level (BL). If BL and INR are improving, we say Sovaldi is working successfully.
Meanwhile, we also monitor the kidney function to observe if any changes occur.
Let me know if you need further clarifications!
Thank you!
Dr.Albana
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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