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24 wks or 48 wks?
Well tonight I take my LAST dose of Incivek, 12 weeks down!!!!!! I go for blood work tomorrow. I was undetectable at week 4. My doctor said that I may be able to finish treatment at 24 wks instead of the full 48 wks. This makes me a little nervous, I don't want relapse because I shortened my treatment. Anyone have any suggestions??? Also have any of you lost the weight you gained while on Incivek? I am feeling huge, 10 lbs heavier than normal.
I also gained at least 15 pounds ,it feels terrible no clothes fitting it is depressing.Now 3 week s later I lost only 2 pounds ,it goes away slow for me .Good luck, hey you are almost done with that Incivek.Hang on there !
I hate to have to be the one to say this, Tom, but it does not look good.
If I am understanding you correctly, your were in triple med treatment with Inf., Riba, Incivek. You were Undetectable at week 4 and continued to be Undetectable through week 24.
Then, at some point after treatment ended, you had a VL of 138,000 and 4 months later it is 69,000.
I do know that viral loads do not stay the same. They can go up and down. Actually, the difference between 138,000 and 69,000 is not much.
The problem is not that the VL is going up and down. The problem is that you have a viral count. That means you still have Hepatitis C.
If I correctly understood everything that you posted, and you were Undetectable at the end of treatment, and you are showing virus now, then I am sorry to have to tell you this, but you had a relapse.
What does your treating doctor have to say about this? He should explain all of this to you. He should also explain what treatment potentially lies ahead for you. There are new drugs in the trial stage and hopefully you will be able to treat with one of them in then future.
Again, I am sorry that you did not attain a cure, but stay positive and hopeful. There are many new drugs coming in the future and you should be able to treat with some of those.
I am just wondering, is this the first time you treated? Or did you treat before, and if so, what happened?
Also, what is your biopsy stage?
If you have a lower stage of fibrosis you have some time and can treat when the new drugs come out. Or, maybe you can get into a trial sooner. Your doctor should be able to explain your options and help get you into a trial if you choose to do that. In the meantime, gaining strength after treatment is very important before embarking on another round of treatment.
Keep us posted, Tom. Let us know how you are doing. Best of luck in the future.
If I am understanding you correctly, your were in triple med treatment with Inf., Riba, Incivek. You were Undetectable at week 4 and continued to be Undetectable through week 24.
Then, at some point after treatment ended, you had a VL of 138,000 and 4 months later it is 69,000.
I do know that viral loads do not stay the same. They can go up and down. Actually, the difference between 138,000 and 69,000 is not much.
The problem is not that the VL is going up and down. The problem is that you have a viral count. That means you still have Hepatitis C.
If I correctly understood everything that you posted, and you were Undetectable at the end of treatment, and you are showing virus now, then I am sorry to have to tell you this, but you had a relapse.
What does your treating doctor have to say about this? He should explain all of this to you. He should also explain what treatment potentially lies ahead for you. There are new drugs in the trial stage and hopefully you will be able to treat with one of them in then future.
Again, I am sorry that you did not attain a cure, but stay positive and hopeful. There are many new drugs coming in the future and you should be able to treat with some of those.
I am just wondering, is this the first time you treated? Or did you treat before, and if so, what happened?
Also, what is your biopsy stage?
If you have a lower stage of fibrosis you have some time and can treat when the new drugs come out. Or, maybe you can get into a trial sooner. Your doctor should be able to explain your options and help get you into a trial if you choose to do that. In the meantime, gaining strength after treatment is very important before embarking on another round of treatment.
Keep us posted, Tom. Let us know how you are doing. Best of luck in the future.
Thank for response, after 4 weeks of treatment, I was alway undetectable until the weeks of 24. Because of my resulted alway undetevtable to the end of treatment The doctor was stop TX, and he believe the viral already gone for good But Pooh why the viral load going down. Thank for your help
Welcome to the forum.
I am not totally clear on a few things.
Did you ever become Undetectable?
Were you Undetectable at the end of treatment?
How long after the end of treatment was the 138,000 viral load drawn?
Viral loads do fluctuate and that could account for the differences in the numbers.
I am not totally clear on a few things.
Did you ever become Undetectable?
Were you Undetectable at the end of treatment?
How long after the end of treatment was the 138,000 viral load drawn?
Viral loads do fluctuate and that could account for the differences in the numbers.
I had triple therapy Incivek , peg and riba for 24 weeks. After TX viral load was 138000. Fours month later viral load down to 69000. Do any body know why.? please help
Hey there, you are the best, thanks so much for the explanation. My doc tried to tell my my odds were lower but after reding your post I feel beeter and believe me feeling better is a big deal
D
D
Your doctor is correct. 24 weeks is the correct protocol for eRVR patients. Data from the ADVANCE trial indicates that you have a 89% chance of SVR if you do 24 weeks.
Data from the ILLUMINATE trial indicates SVR rates of 92% for 24 weeks vs. 88% for 48 weeks of treatment. Statistically there is no difference. Nothing is gain by doing more than 24 weeks.
It doesn't get much better than that!
"Selecting a Treatment Regimen: Response-Guided Therapy"
"• Response-guided therapy is recommended when using telaprevir-based triple therapy for treatment-naive patients and previous relapsers. All patients should receive 12 weeks of triple therapy, followed by a period of pegIFN/RBV alone.
The duration of pegIFN/RBV is based on achievement of undetectable HCV RNA at both Week 4 and Week 12.
- Patients who meet this criterion should receive a total of 24 WEEKS of therapy (12 weeks of triple therapy followed by 12 weeks of pegIFN/RBV alone), and
- patients who do not should receive a total of 48 WEEKS of therapy (12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV alone).
• All previous partial or null responders and cirrhotic patients treated with telaprevir should receive a fixed-duration 48-week course of therapy (12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV alone). Tolerability should be followed closely in patients with cirrhosis."
....
"The response-guided therapy strategy with telaprevir is based on the results of 2 phase III trials in treatment-naive patients. Results from the ADVANCE trial strongly suggested that 24 weeks of therapy is sufficient for patients with eRVR. In the T12PR48 arm of this trial, patients with an eRVR received 12 weeks of triple therapy followed by 12 weeks of pegIFN/RBV, whereas patients without an eRVR received 12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV.
Among patients who achieved an eRVR and received 24 total weeks of therapy, the SVR rate was 89%, confirming that this strategy results in a very high SVR rate.
The robustness of response-guided therapy was confirmed by the ILLUMINATE trial, in which treatment-naive patients with genotype 1 HCV who achieved eRVR after 12 weeks of telaprevir were randomized to receive either 12 weeks or 36 weeks of pegIFN/RBV, for a total therapy duration of 24 or 48 weeks, respectively. Among patients with eRVR, 92% achieved SVR with 24 total weeks of therapy vs 88% with 48 total weeks of therapy.
Patients who did not achieve eRVR all continued pegIFN/RBV through Week 48, and 64% attained SVR. "
Looks like you are on your way to a life free of hepatitis C!
Hector
Data from the ILLUMINATE trial indicates SVR rates of 92% for 24 weeks vs. 88% for 48 weeks of treatment. Statistically there is no difference. Nothing is gain by doing more than 24 weeks.
It doesn't get much better than that!
"Selecting a Treatment Regimen: Response-Guided Therapy"
"• Response-guided therapy is recommended when using telaprevir-based triple therapy for treatment-naive patients and previous relapsers. All patients should receive 12 weeks of triple therapy, followed by a period of pegIFN/RBV alone.
The duration of pegIFN/RBV is based on achievement of undetectable HCV RNA at both Week 4 and Week 12.
- Patients who meet this criterion should receive a total of 24 WEEKS of therapy (12 weeks of triple therapy followed by 12 weeks of pegIFN/RBV alone), and
- patients who do not should receive a total of 48 WEEKS of therapy (12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV alone).
• All previous partial or null responders and cirrhotic patients treated with telaprevir should receive a fixed-duration 48-week course of therapy (12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV alone). Tolerability should be followed closely in patients with cirrhosis."
....
"The response-guided therapy strategy with telaprevir is based on the results of 2 phase III trials in treatment-naive patients. Results from the ADVANCE trial strongly suggested that 24 weeks of therapy is sufficient for patients with eRVR. In the T12PR48 arm of this trial, patients with an eRVR received 12 weeks of triple therapy followed by 12 weeks of pegIFN/RBV, whereas patients without an eRVR received 12 weeks of triple therapy followed by 36 weeks of pegIFN/RBV.
Among patients who achieved an eRVR and received 24 total weeks of therapy, the SVR rate was 89%, confirming that this strategy results in a very high SVR rate.
The robustness of response-guided therapy was confirmed by the ILLUMINATE trial, in which treatment-naive patients with genotype 1 HCV who achieved eRVR after 12 weeks of telaprevir were randomized to receive either 12 weeks or 36 weeks of pegIFN/RBV, for a total therapy duration of 24 or 48 weeks, respectively. Among patients with eRVR, 92% achieved SVR with 24 total weeks of therapy vs 88% with 48 total weeks of therapy.
Patients who did not achieve eRVR all continued pegIFN/RBV through Week 48, and 64% attained SVR. "
Looks like you are on your way to a life free of hepatitis C!
Hector
We do know that the SVR rates were lower for partials and nulls with 48 weeks. I don't think I've seen any data either on 24 wks. Your circumstances are certainly different, nothing really definitive to actually establish you as a null considering the inconsistencies in your previous treatments.
Go with what you feel will be appropriate. If you opt for the shorter duration the one thing you can be certain of is there will be and end result, good or bad. Even though the DAA's are the best game in town right now, there are still no certainties even when the odds are stacked in your favor.
Go with what you feel will be appropriate. If you opt for the shorter duration the one thing you can be certain of is there will be and end result, good or bad. Even though the DAA's are the best game in town right now, there are still no certainties even when the odds are stacked in your favor.
Have you found any info on the percentage of SVR between 24 and 48wks, if you null or partial before. I keep seeing "its protocal" to go 48wks if you meet these criteria, but whos protocol, and what is the difference for these people? I see 2 or 3% for naive, so what is it for null or partial? If its still only 2 or 3% then is the exposure to tx worth the risk? Vertex says 2 or 3% is insignificant. I would sure like to hear some hard numbers because quite frankly I dont beleive all I hear from the tx industry as a whole.
Good lord yes....I am so depressed I have gained like 15 pounds my clothes are tight and I hate it. I can't wait for four more weeks then off the incivek..I don't know how I'm going to do it but If I have to drag myself to the gym I will. God Bless
If the 12 wk PCR is UND than you are eRVR. In the trials, there was only a very small increase in SVR rates between the 24 & 48 wk group who had eRVR. Actually the difference, maybe 2 or 3 percent was considered insignificant by Vertex. If you treated previously and were a null or partial responder protocol dictates 48 weeks. Those with cirrhosis may benefit from 48 weeks as well.
Not at all unusual to gain weight while taking Incivek. I'll come off as you continue with the P/R.
Not at all unusual to gain weight while taking Incivek. I'll come off as you continue with the P/R.
If you are still UND at week 12 the protocol is 24 weeks total with no difference in SVR rates acoording to study data if you are tx. naive.
Best
Will
http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/ucm256328.htm
The SVR rate for all subjects enrolled in the trial was 74%. A total of 352 (65%) subjects achieved eRVR and of those 322 (60%) were randomized to 24 weeks (T12/PR24, n=162) or 48 weeks (T12/PR48, n=160) of treatment. The SVR rates were similar at 92% (T12/PR24) and 90% (T12/PR48), respectively. Again, small numbers of subjects were enrolled in some key subgroups:
Best
Will
http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/ucm256328.htm
The SVR rate for all subjects enrolled in the trial was 74%. A total of 352 (65%) subjects achieved eRVR and of those 322 (60%) were randomized to 24 weeks (T12/PR24, n=162) or 48 weeks (T12/PR48, n=160) of treatment. The SVR rates were similar at 92% (T12/PR24) and 90% (T12/PR48), respectively. Again, small numbers of subjects were enrolled in some key subgroups:
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