24 week treatment for subset of geno 1:s approved in Europe

[zazza]

With a baseline viral load less than 600'000 IU/ml and an UND at week 4 with a sensitive test, genotype 1:s (both 1a and 1b)in Europe are approved to go for only 24 weeks. Is this not so in the US? The Zeuzem study which jmjm530 refers to in a thread down below "to jmjm530" shows that the predicted SVR is the same for this subset with 24 as well as 48 weeks. Currently there is a new study with something like 2500 participants in Europe to once again verify this, but the shorter treatment length is already approved.

A small warning: this promise of shorter treatment was why I started treatment. (Since I had a baseline viral load of below 250'000 IU/ml, I had 68% chance of belonging to this lucky subset who could go 24 weeks). I intended to stop at week 4, if not UND. But by the time I got the test result being detectable at week 4, I was already half way to week 12, and so I thought I would see if I was UND by week 12 and then quit if not. It is difficult to quit once you have started fighting this virus.

I managed to just miss UND by week 12, but was UND by week 15, and now I am looking at 72 weeks of treatment. As I say, it is hard to stop once you begin. But really, I think this is the future of SOC for geno 1:s with a low viral load: individualizing treatment by doing viral load tests at week 4, 12 and 20, and deciding duration of treatment by when UND.

[Eisbein]

To me - it wasn't how quickly I could finish treatment but how great I could improve my chances at success.

Very well said nygirl, and I sure hope you will be rewarded with SVR.
I am looking every day for your test results, hope I didn't miss your post.

Ina

[nygirl7]

I agree with Ina 100%

60 really is not the optimal number - there is no study data to backup a claim that it is more effective than doing 48.  72 on the other hand greatly changes the percentages of relapse.

The additional little 12 weeks was fully WORTH a better chance at having a 1/3rd chance (basically) of a relapse compared to a 1/2 chance of it.

Once you've made it to 60 - it's dowhill from there and the peace of mind I have that I did all I could do and never have to second guess my decision was WELL worth it.

To me - it wasn't how quickly I could finish treatment but how great I could improve my chances at success.

(I have two genotypes so I DID research this as well as I could).

[Eisbein]

I translated the German study you linked, it's on the other forum, about 3 pages back, under Tallblonde.
If you can do 60 weeks, you can do 72, and 72 is what the study said would give you the greatest chance of SVR.
Just think if you relapse after 60 weeks, you will forever ask yourself  if you could have made it with 72. You would have to start all over again, and expose yourself again to more drugs.
Do it once and go the distance, go by what the researchers say, and  forget the rest.

Good luck
Ina

[jmjm530]

Thanks for sharing your experience. Yes, I imagine it is difficult to stop after getting the week 4 results, but nevertheless I believe that stopping at week 4 is an excellent strategy for those selected geno 1's without significant liver damage who are still detectible at week 4 and don't want to expose themselves longer than 24 weeks to the treatment drugs. I wish you well with extended treatment, although personally I wouldn't go 72 weeks unless I had significant liver damage, but would probably just add 36 weeks to when you became detectible which would be a total of  51 weeks, or possibly make it 60 for good measure. Definitely a compromise in terms of your chance of SVR, but also a compromise in terms of exposing yourself to the drugs. But then again, I wouldn't treat anyway without significant liver damage so my take different from many here.

-- Jim

[antman]

zazza,
i think your reasoning makes sense. and based on the research i've seen it's only if und at week 4 would one even consider 24 weeks. i don't fall into that catagory. after 6 weeks i had a VL of 21,600- down from 3 mil before start of tx. i see the Dr. Mar 28. that will be at week 10. i'll ask for a VL test then. so IF i'm UND then or at 12 weeks i go 48 weeks (1a). the big test though is 12 weeks. if you go by the model where you add 36 weeks to the time you UND, that would be 48 weeks at week 12. make sense? i hate to go 72 weeks but if i still have a VL at week 12 i don't see much of a choice.