Firstly, many thanks to 3txsofar for posting the link http://seekingalpha.com/article/34029
I think there's a very important insight here. It has always bothered me why Vertex would think that they could shorted tx duration to 24 weeks. I could see that VX950 could bring about UND very fast, but after that point wouldn't the virus have to be UND the same length of time as for SOC?
To me, this applied especially to the 12+12 regimen. As I see it, RVR on the triple therapy cannot be translated to RVR on SOC alone. RVR is a measure of viral kinetics, and the viral kinetics on the triple therapy are very different than on SOC alone. It never made sense to me to assume that RVR on triple therapy for 12 weeks translated linearly to faster elimination of the virus on SOC for the 2nd 12 weeks.
Anyway, Vertex has explained their thinking in the above article. They reckon that VX950 puts down just about all the wild type virus very quickly. What's left are the resistant variants and these require the 24 weeks of SOC to put them down. Implied in this is that these variants are not as replicatively fit as the wild type virus which would require 48 weeks SOC. So they are looking at these variants as if they were like the geno2 or geno3 viruses which we know can be put down in 24 weeks.
Well, for the first time I have to say that I can actually buy this. But we won't know for sure till the relapse figures for the 12+12 are disclosed .
I've always thought the same thing. It's wonderful to have the RVR but since a blood test can't "really" tell if one is UND or not - to ME the protocol of going longer is there in order to train your bodies immune system to kill the rest and assist it in doing so AND in order to try and kill off any mutants that are hiding somewhere other than the bloodstream.
Of course, that is my logic and might make less sense.
Since my goal has always been SVR and not just RVR I have always thought that taking VErtex in the beginning AND continuing with regular SOC would be the best way to go - sort of a double banger. It doesn't stop with RVR the goal is SVR and that is a huge difference.
Good post - very interesting, thanks for posting it.
I understand wild type virus to be the HCV virus as it is pre-treatment. Once treatment starts other mutations might occur, or some quasies or strains might become a larger proportion of the remaining virus population because they are more resistant to treatment than others.
I had to stop by and say thanks for posting the link too. I read (very slowly) what the folks were saying and it clicked for me too. Now it makes sense and just adds to my feeling that we took a baby step forward with the development of TVR.
I found my one good thing to make the day worthwhile in your postings and I thank you for that too. I'd take the information with me to my counselor appointment today, but I'm not sure she'd understand it all. I was just so glad when the light came on as I understood what Vertex was accomplishing.
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