Boceprevir

Does anyone know if the results in genotype 3 patients using boceprevir are approximately the same as those using telaprevir? Thanks.

[Rockerforlife]

From what i gather,no TX is being done on geno 2/3 with the protease inhibitors, but i do beleive trails are being done with the polmerase inhibitors on the geno 2/3.

[HopefulinScotland]

Well, I know there has been at least some studies done on G 2/3 for telaprevir, because I've heard it doesn't work.

I'm looking for info on Boceprevir and Genotype 3, too. (BTW, I hate seeing 2 and 3 lumped together. They're very different in many ways and we 3's are often told stats that are skewed by the stats for genotype 2.)

[Marcia2202]

So true... They have started not lumping them together. It is encouraging that they don't.

From what I remember is that g2 reacted fine to Tela, but g3 did not do well at all.

If I remember correctly, I don't think they have been doing any BOC trials for g3's, as it is too similar to Tela.

[HopefulinScotland]

What I've heard is that there's nothing really on the horizon G3's. Meanwhile, we may have the fastest rate of fibrosis:

http://www.hivandhepatitis.com/hep_c/news/2009/102709_a.html

[newleaf09]

http://www.hivandhepatitis.com/2009icr/easl/pdf/Preclinical_FNL.pdf is link to a poster from the very early trials.  They said it had activity against 3a.  I'll keep looking, but it seems that they targeted geno 1 once they got into the phase 2 and 3 trials.  Of course the major market is with geno 1's since it's the major geno in the US, but that does not mean it is not effective against other geno's.  The trials just haven't concentrated on them.  Look back at the earliest studies, most of which are reported on hivandhepatitis.com in the experimental drugs section.

[Rockerforlife]

Geno 2,errr 3  has a 80% cure i think,so this is another reason why the compainies are concentrating on the geno 1`s

[HopefulinScotland]

No, Rocker... Genotype 3 does NOT have a 80% rate of SVR with the current standard treatment. It's more like 60-65%.

Lumping the two genotypes together has confused a lot of people... Genotype 2 is much more responsive to tx than genotype 3.

Newleaf, I am encouraged to hear this! I know that Teleprevir has been found pretty much useless for genotype 3 and it would be nice to learn that there could be better success with Boceprevir.

I am about to start tx in January and I will feel better knowing there could be a fall-back in case I don't achieve SVR. :)

[Rockerforlife]

Just curious,do you have study papers that state geno 3 is only 60-65% cure rate,maybe geno 2 has the 80-85% rate.Il try to find the trial paper again

[HopefulinScotland]

Not one particular study - those are just the numbers I've seen in a lot of places. I'm not so sure about the SVR rate for G2, as I'm primarily concerned about G3. :)

Here's a pertinent article:

http://www.hepctrust.org.uk/news/2008/April/EASL+HCV+Genotype+2+And+3+Respond+Differently+To+Anti+HCV+Treatment.htm

[BelB64]

There are actually many drugs that will be effective against genotype 3. Right now Pharmasset's polymerase inhibitor R7128 is VERY effective against geno's 2 and 3 in similar numbers. 90% of geno 2's and 3's of non responders achieved RVR after 4 weeks with SOC.

Avila has a new drug AVL-181 it's testing that's a small molecule protease inhibitor that's "demonstrated inhibition across multiple genotypes"

Many other trials are beginning with drugs that are effective across all genotypes. Even though Geno 1 is the dominant genotype 20% -30% of the world's HCV population is genotype 2 and 3 which translates to tens of millions of potential patients. This is why any drugs that are effective against all genotypes will be the ones to potentially make the most money.

[HopefulinScotland]

It's nice to hear that!

[RCM829]

Yes, Belb64 is correct.

In addition to R7128 (which is the front runner), there are several drugs  in the pipeline that currently appear to be very effective for us geno 3's.

One of my doctors - a prominent liver transplant doctor in California - told me these drugs are still at least 3 to 5 years away from FDA approval however.

Good luck with your treatment!

[jessiejames1973]

r7128
could be ten years away

[Bali05]

could not agree more .
lumping genos together *****.

anybody know anything referring to geno 4 and the new drugs?

[Rockerforlife]

SVR was significantly lower in HCV G3 (80%) than in HCV G2 (94%; p 0.002).

I read this in your post,so wasnt my statement correct?...

[hamsterxyz]

Alinia in combination with SOC could be effective against gen 3. Its been proven to be effective against both gen 1 and gen 4 and is a broad spectrum antibiotic. It is already an approved drug for giordia and can be taken off label. Access is tricky. If your insurance co. won't cover it for Hep C it is prohibitively expensive at $700 a month. A generic version from a Canadian pharmacy, however, is approximately $100 a month.

[CoWriter]

Grom "Tailored Treatment for Hepatitis C" by Thomas Berg, MD

"In patients who did not have RVRs, end-of-treatment response rates ranged from 65% to 76% across the four treatment groups"

It is no longer appropriate to generalize that patients who have HCV genotype 1 and 4 are ‘‘difficult to cure’’ because of viral kinetic evidence to the contrary. Conversely, it is no longer appropriate to think of all patients who have HCV genotype 2 or 3 as ‘‘easy to cure.’’ Although genotype is an important driver of response and is useful in designing the initial treatment plan, it is clear that once treatment is initiated, RVR is the most important and powerful predictor of SVR."

Co