23 weeks sofo & ribavarin gt 1a f2

[printze]

My doctor wants to treat with 24 weeks of Sofosbuvir & Ribavarin he says I am not eligible for interferon feels I am too nervous of a person . Are my chances of curing the same as 12 weeks with triple combo ?

[Dee1956]

Hey there, good decision.  I had anxiety before treating and was still able to get through the Incivek, Peg and Riba.  It was very hard but I did it and am now considered cured.  I did have to take anti anxiety medication but it was so worth it.  Because I had been diagnosed with beginning cirrhosis I was afraid but glad I did it.
I wish you all the best.

[printze]

Thanks for the imput , I would much rather do the 12 weeks and give my liver a  90% chance than the longer treatment at only 70%. I will advise my case nurse that is my decision . I agree, I am F2  and do not want to progress to F3 .

[hrsepwrguy]

I would call it more like 70% without interferon for geno 1's, if it were me (and I know your case well) I would do the 12 wks with interferon for a 90% SVR rate, IMHO I wouldn't want to progress to stage 3

Have a great day

[printze]

I  have read all these reports and I get so confused with all the numbers . Is it correct to say that I have about  a 50-60 % chance at 24 weeks ? The more I read statistics the more confused I get .I am going to ask my   doctor I want to go ahead with the 12 weeks incl interferon.I know he has already written the prescription forms and is giving them to the case nurse who I am supposed to call at the end of May. I am allowed to ask him to change it before we approach my insurance company and Gilead momentum for assistance ? If accepted my insurance will pay 80% and hopefully Gilead momentum will pick the difference . I will know more in 2 weeks .Any suggestions ?

[hrsepwrguy]

Sofosbuvir in Treatment-naive HCV Type 1-infected Patients

In the QUANTUM and ELECTRON studies, sofosbuvir was given for 12 weeks in combination with RBV to overall 50 treatment-naive patients with HCV type 1 infection.[23,27] SVR12 was observed in 56% and 88% of patients, respectively (mean of 70%). Prolongation of this dual combination treatment to 24 weeks seemed not implicitly to increase in SVR rates, as the overall SVR12 rate was 52% and 90%, respectively (mean 67%) in 35 patients of the QUANTUM and NIH SPARE studies

[nan535]

My husband is post transplant with cirrhosis. He is on week 14 of the 24 week Sovaldi/Ribavirin treatment. He is geno 1a but ineligible for interferon, hence, the decision to treat for 24 weeks. There is a possibility he may treat longer as the guidelines recommend up to 48 weeks. He has had to take a low dose of the ribavirin due to lower hemoglobin and moderate kidney issues.

We are not sure how this will turn out in terms of reaching SVR but the fact is
this treatment has stopped the virus in its tracks and therefore it is no longer causing further damage to his new liver.  If he does not reach SVR at EOT,
then the plan is to go with the Sovaldi/Ledipasvir combo pill when it is available.

Good luck to all in reaching SVR .

Nan

[printze]

Thank you Hector, I read that as well but I did not see what the cure rate was for 24 weeks gt 1a F2 . I tried searching but seen nothing ( unless I missed it ) I also live in Canada and we will not be getting the new drugs coming out later this year in the U.S sofo & ledisprevir . If we do maybe sometime end of 2015 hopefully before , not optimistic it always takes longer for us to get new drugs approved up here .

[HectorSF]

There are numerous factors that affect outcome. The largest one being whether a person has cirrhosis or not. While hep C can be cured in cirrhotics they are harder to cure than others.

"Are my chances of curing the same as 12 weeks with triple combo ?"

Treatment-Naïve Adults Response Rates in Study NEUTRINO (SOVALDI + Peg-IFN alfa + RBV 12 weeks)
Genotype 1a - 92% (206/225)
Genotype 1b - 82% (54/66)
With cirrhosis - 80% (43/54)

Genotype 1, Metavir F3/F4 fibrosis, IL28B non-C/C, HCV RNA >800,000 IU/mL  - 71% (37/52)
SVR rates were 98% (93/95) in subjects with baseline IL28B C/C allele and 87% (202/232) in subjects with baseline IL28B non-C/C alleles.

It is estimated that the response rate in patients who previously failed pegylated interferon and ribavirin therapy will approximate the observed response rate in NEUTRINO subjects with multiple baseline factors traditionally associated with a lower response to interferon-based treatment (Table 9). The SVR rate in the NEUTRINO trial in genotype 1 subjects with IL28B non-C/C alleles, HCV RNA >800,000 IU/mL and Metavir F3/F4 fibrosis was 71% (37/52).
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The AASLD (American Association for the Study of Liver Diseases)
Recommended regimen for treatment-naive patients with HCV genotype 1 who are NOT eligible to receive IFN.

Daily sofosbuvir (400 mg) plus simeprevir (150 mg), with or without weight-based RBV (1000 mg [75 kg] for 12 weeks is RECOMMEND for IFN-ineligible patients with HCV genotype 1 infection, regardless of subtype.

Sovaldi + ribavirin for 24 weeks is the ALTERNATIVE recommended treatment if your health insurance policy do not cover off-label use of Olysio. Most insurance will with proper justification from your doctor's office.
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SVR12 Among Patient Subgroups with Genotype 1 HCV and METAVIR Scores of F0-F2 in Cohort 1 of the COSMOS Study
Simeprevir/Sofosbuvir (%) SVR
IL28B CT - 100%
IL28B TT - 67
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SVR12 Among Patients with Genotype 1 HCV and Advanced Liver Fibrosis (F3-F4) in Cohort 2 of the COSMOS Study
Genotype 1a HCV without the Q80K polymorphism - 88%
Genotype 1a HCV with the Q80K polymorphism - 100%
METAVIR F4 - 86%
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Good luck with your treatment!
Hector

[printze]

I too would like to hear from others on this tx regimen both cirrohtics and non cirrhotics. As much as I have expressed my fear to him of interferon, I would still rather do 12 weeks including interferon  and have a higher cure rate than do a longer treatment and have reduced my chances of svr if that is the case .

[Jeanlee14]

Hi I'm going to be on the same treatment and I'm geno 1a with cirrhosis I have heard it has a 75 percent cure rate  but you have a good chance not having cirrhosis waiting to here so.e SVR with this group of people

[printze]

I meant 24 weeks on my post