I found my first shred of evidence that tx can be stopped as early as 12 weeks and still have "a high likelihood of getting rid of the virus"
QUOTE from WWW.CAP.ORG,
Another example would be a patient who had a rapid virological response and some significant side effect, Dr. Dufour says. “We’re probably much more likely with that patient to see what we can do to manage the complications and maybe get them through at least 12 weeks of treatment, because they have a high likelihood of getting rid of the virus.” With someone who hasn’t had much response at four weeks and has significant side effects, “we’re not going to press them as hard to continue as somebody who’s having a rapid virological response.”
Since the release of Victrelis and Incivek those patients who have been treating with triple therapy are just now reaching 12 weeks. With Incivek, non cirrhotics, treatment naives and relapsers who were UND at week 4 & 12 qualify for the shorter treatment duration which is 24 weeks.
As time passes there will many posters who will treating for 24 weeks because there are many who are UND at the 4 week mark which is a good indication they will be UND at week 12 as well, however, dose reduction must be taken into consideration during the first 12 weeks as it can impact on viral clearance.
Even before the protease inhibitors came along there have been people who've had to be pulled off tx early and still gotten a sustained response. This seems to be largely a matter of genetics and is a good reason to do an IL28B test before treating and to do early and frequent PCRs while doing tx. Personally, I've known another geno 3e who got an SVR with 16 weeks and a geno 1 who did the same with 24 and I've heard of others who've gotten away with even less. But these are the exceptions rather than the rule. As long as your side effects are tolerable it's best to do the full course of tx.
The "first shred of evidence" is misquoted; taken out of context.
It's a good article, a long article, and the section you quote is at the very end. What they are talking about is the group of super responders; not people who *merely* RVR, but probably people who all are clear in days, and possibly not more than a week of triple therapy.
THAT GROUP, that subset of triple therapy treaters would have a "high likelihood" of success after only 12 weeks of triple therapy.
Main point is that the rough aggregate of triple therapy treaters do NOT have a high percentage of success treating only 12 weeks.
I believe the first shred of actual evidence was during the very first Vertex phase 2 a trials in which they allowed people clear at week 4 and 10 weeks the chance to end TX at 12 weeks. (I believe about 2006) It was a very small group who did this; 20 people. Of those 20 people who completed the 12 weeks 6/ 9 were clear at 20 weeks post TX. Deriving a meaningful statistic is tough w/ such a small group, especially when the final amount was smaller still. However, it was proven to be possible.
The bottom line is that yes, it is possible, and something like 5 years after this test they have a much better means of predicting and getting people to the 12 week TX time........
...the average, the aggregate geno 1 treater does NOT have a high likelihood of being able to treat with only 12 weeks successfully with current approved drugs but rather that may be true for a smaller group of super responders.
Good article. For what it's worth, Vertex is currently testing quad and triple therapy for 3 weeks with DDA's and we may get some interim results at this fall AASLD. Reportedly, the quad therapy is successful and they are now testing a 5th arm w/ the DDA's w/ riba.
The reason Im looking for any shred of hope for not relapsing is because my Dr is taking me off tx for being intolerant. Im still fighting to stay on tx but sores and rashes are out of control.
Thanks desrt, Ive read a bit about the genetics and hope to be in the exception as Ive had all und labs from week 4. Your reply helps me to stay positive and I will check in at 6 months post tx to let you know.
Hey, i see you only have 3 posts. I don't know your situation.....
Why don't you post about your situation to get some feedback?
I'd suggest including info about what week in TX you are in, info about the sides which are causing your doctor to stop TX, your response to TX (rate of viral decline).
I'm reading between the lines here, but are you suggesting that your TX is being stopped due to the triple therapy stopping protocols? Or the severity of your rash? Is the doctor ending triple therapy or the SOC which follows?
You get the drift....
Sorry, I didn't know your situation, I wasn't trying to be discouraging, but rather precise about peoples odds in doing 12 weeks only w/ triple therapy.
I was in a trial for Incivek. When the trial was unblinded, I learned that I had only gotten the Incivek for the first 8 weeks. I completed the next 16 weeks getting just SOC. I've been SVR now for more than 2 years. Is this the med you're taking? If you are taking Incivek and this drug is discontinued the skin problems usually clear up in a short time, at least from what I've heard.
I've also heard some amazing stories of people who had to stop all the meds early and still got SVR. I guess it's a chance you take if you have to stop tx. Wishing the best possible outcome for you...
Did you mention what your genotype is? Did you start with triple and now down to Inf/Riba after 12 weeks? Also, are you in a trial?
It does sound like you are having a very rough time, but there are many others here going through much the same. Rashes and sores can be unbearable, but they can be managed if treated properly. If this is possible, it sure would give you a better odds to get to SVR, rather than hoping to be an exception. As Willy said, some more information would help the forum members offer you some suggestions.
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