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Combo Therapy User Says “No” to Amevive
from Don H.

Backstory:  Good Results from Combo Therapy

Ed, I wrote late last summer describing spectacular results with Dovonex/Ultravate therapy — from 70+% coverage to near clear within one week.  The great results lasted for about 6 months of two applications per day, Dovonex in the morning and Ultravate in the evening.  And then one day the lesions slowly began to return.  They were not as large or as angry (crusty) as pre-treatment, but the effectiveness was clearly diminishing.  Thanks to an insurance issue that took a couple months to resolve I spent that period of time with no treatment, and interestingly enough, basically held at a steady state.

Most recently I've begun a combination of Dovonex/DermaZinc (0.25% zinc pyrithione).  After about 5 weeks into this, results are looking good.  Lesions are considerably smoothed and with tanning treatments, reasonably camouflaged (my daughter says if I was a rap star I should be named "Cheeta").  Perhaps we're on the front edge of another 6 month cycle. 

I received an information packet in the mail today regarding Amevive, and dug into this with great interest.  I was predisposed to jump at this therapy from the previous readings, but after reviewing their clinical data, this is not for me.  The response versus placebo is good, with decent probability of significant improvement.  But for me, the malignancy rate (almost 2%, 25/1357) is totally unacceptable.  Psoriasis might not be pretty, but it isn't life threatening.  Side-effects of possible dizziness and headaches for significant cosmetic improvement is one thing.  Lymphoma is another.  We'll all have a different calculus for our given situations.  For me, this isn't even close.

Keep up the good work with this site.  You are providing an invaluable service and sounding board, and for that I thank you again. -Don H.

*****

Ed’s Response:  Thanks, Don.  I hate statistics for two reasons, (1) they’re only important if they’re self-defeating, and (2) they’re meaningless to the fellow who wins the lottery.  Cuteness aside, statistics, I feel, provide a very narrow macro-view of reality.  They’re only good for planning large things, like government programs.

Anyway, having said all that, I tried to use some statistics myself.  From The American Cancer Society I learned that about 1.334 million cases of cancer in the U.S. are projected for 2003.  From the U.S. Census bureau (where statistics are absolutely a Mysterious Art, to which I am not allowed knowledge) I sort of concluded the U.S. population is predicted to be about 279 million in 2003.  Playing at the uncertain art myself, this would suggest almost one half of one percent of the population will have cancer (1.334/279=.0047 or .47%).  If this is anywhere near accurate, Amevive’s predicted 2% malignancy rate would seem to mean an Amevive user is a little over four times more likely to have cancer than a non-Amevive user in America.

You’re right, this kind of calculus becomes very personal.  But I think it only fair to suggest this picture is rendered in very few shades of gray.  For a better “understanding” we would want to ask lots of questions about other cancer predispositions that might make the potential Amevive-user population not representative of the population at large (that is, more likely to get cancer than population averages).  I don’t even know, and it would be interesting to know, what the percentage of flakers with cancer is.  (I know it just increased by one case — me.)

Sounds like you’re actually using a three part combination therapy, Don.  It’s three if you add the “tanning treatments” to the Dovonex and DermaZinc.

I’m glad you brought the DermaZinc combo to our attention.  Others who might be having little or no luck with Dovonex alone, and who don’t want to spring for another expensive topical (like betamethasone), might want to try the DermaZinc.  (And, just for that lucky edge, a little “tanning treatment” might not hurt, either.)

Stay in touch, Don — er, Cheeta. -Ed

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