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All kidding aside Boceprevir is a very good PI and right up there with Telaprevir. There was some recent news about Shering-Plough misrepresenting trial data but regardless my doc said it is just as good. He has both trials going on at his office so I heard this from the "horses mouth". Best of luck
http://findarticles.com/p/articles/mi_m4PRN/is_2008_May_21/ai_n25487875
http://www.hivandhepatitis.com/hep_c/news/2008/080508_c.html
"These top-line results with boceprevir are very exciting, especially given that genotype 1 is the most common and hardest to treat form of hepatitis C," said Paul Kwo, M.D., associate professor of medicine and medical director, liver transplantation, Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, and lead investigator of the study. "Boceprevir was well tolerated by patients in this study, including those who received 48 weeks of boceprevir in the longer duration treatment arms."
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The new vetex trial is ALSO 48 weeks of tx, not 24. And if vertex still don't allow "rescue" drugs then i'm sure their dropout rate will be higher, or they will have to lower the dosage. Either way not good. I would have never made it thru 48 weeks of tx without procrit. It seems like alot of people here need procrit to stay on tx, or to keep from having their meds reduced.... Boceprevir does allow procrit.
Also the p/r lead-in results look better then the no lead-in arms. Both arms with Boceprevir trial is lead-in, and only one of the vertex is.
Rocker, best to you, good choice, and i hope to be following you.
cando
Congrats! I'm so happy for you. You're gonna kill this bugger!!! I pray you get the real stuff, you deserve it sssoooo bad!
Marcia
I just saw a new webcast presentation that showed that even though NAIVE patients did well on Boceprevir......NON-RESPONDERS didn't.....SVR was only 7-14%
Phase II Boceprevir/Peg/Riba.....Non-Responder study, Genotype 1
SVR 7-14% (in the 3 different arms).
And 8-12% discontinued treatment for adverse events in the 3 Boceprevir arms vs 5% for Peg/Riba.
Here's the webcast presentation the info came from. You may need to register to access it....
http://www.clinicianschannel.com/PIK/1813/1813Webcast.html
cando
http://clinicaltrials.gov/ct2/show/NCT00708500?recr=open&cond=%22Digestive+System+Diseases%22&rank=29
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This would include relapsers.... Right???
cando getting confused
http://biz.yahoo.com/prnews/080804/nym051b.html?.v=1
And yes a relapser is und at the end of tx but then the virus returns. So relapsers are good to go in this new trial...
http://findarticles.com/p/articles/mi_m4PRN/is_2008_May_21/ai_n25487875
phase 3 was only for naive patients....are you sure you are reading this correct ms writer???????????
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As for the phase 3 trials there will be two different ones....
One study will be in previously untreated (naive) patients and the other in patients who failed prior treatment (relapsers and nonresponders),
Hope this helps
cando
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KENILWORTH, N.J., May 21 /PRNewswire-FirstCall/ -- Schering-Plough Corporation , a leader in hepatitis research, today announced that it is initiating two large Phase III studies of boceprevir, its investigational oral hepatitis C protease inhibitor, in patients chronically infected with hepatitis C virus (HCV) genotype 1. One study will be in previously untreated (naive) patients and the other in patients who failed prior treatment (relapsers and nonresponders),
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Phase 3 will have seperate studys, the one were interested in is for relapsers and nonresponders. The other study will be for treatment navie patients.
cando
http://clinicaltrials.gov/ct2/show/NCT00708500?recr=open&cond=%22Digestive+System+Diseases%22&rank=29
http://www.clinicaltrials.gov/ct2/show/NCT00705432?term=Boceprevir&rank=1
:)
Yeah, I'm sure.
Look at the 5th topic called.....
"Can Stat-C Therapies Change the Course of HCV Infection in the Future?"
Go to Slide #34
At the top of the slide it says.....
"Boceprevir+PEG INT/RBV Phase II Non-responder, Genotype 1"
It shows a graph with.....
A hot pink section for .....PEG INT 2b +RBV.....shows SVR 2%
Blue section for .....Boceprevir+ PEG INT 2b+ RBV(various arms)....shows 7-14% SVR
And the speaker said this was final data and added, "It's a sobering reminder that non-responders are going to have different patterns of response than naive patients."
wk 4=318,000...2 log drop
wk 8=3000........2 log drop
wk 12=300........ 1 log drop
so iha a 5 log drop from baseline in 12 weeks but i cleared some where between wk 12 and 24...im a slow responder...not a non responder...i know my odds are not much bteer but its better than nothing....im thinking i would have a better chance if i did 72 weeks o SOC....any suggestions???.
"Not seen the webcast, but wasn't the last trial for Treatment-Naive only?"
"Boceprevir in Null Responders
The results from another study using boceprevir in combination with PegIntron plus ribavirin yielded less promising outcomes.
In the study there were 357 genotype 1 patients enrolled who were deemed prior null responders – defined as either less than a 2 log10 drop in HCV RNA after 12 weeks of therapy with pegylated interferon/ribavirin therapy or who did not achieve undetectable HCV RNA if treated longer than 12 weeks. There were 7 arms in this study – with or without different doses of boceprevir (100, 200, 400, 800 mg), and with and without ribavirin. This study had a lead-in phase using PegIntron alone.
The authors found that boceprevir is safe and well-tolerated. The overall intent-to-treat sustained virological response rates were 2% in the group that only received PegIntron plus ribavirin and up to 14% in the groups that received triple combination of PegIntron, ribavirin and boceprevir. It was found that the most effective dose of boceprevir was 800 mg TID and that the use of ribavirin would be required to optimize treatment outcome. The treatment duration would include an additional 24 weeks after HCV RNA became undetectable."
http://janis7hepc.com/Hepatitis%20C%202008%20New%20Inhibitors.htm
"...i fall into the null responders,,,i had large log drops i the 12 weeks i treated."
You have it backwards. A "null responder" is someone who did NOT get a 2 log drop by week 12.
Marcia
I don't know how it works, just wondering.
Marcia
Marcia
I don't know because I don't know what the outcome of your treatment was. All I know is that you got >2 log drop at week 12......and you cleared at week 24.
What happened after that? Did you finish 48 weeks? Did you remain clear until week 48? When did the virus come back?
He cleared (at week 24) and then he didn't clear at the end. I guess that makes him a tease.
LOL
You are a relapser...
I think you should follow your feeling... If you don't want to take the risk of ending up in the placebo arm and thus having done 48 for nothing... If your doc is agreeing to treat aggressively and you think he is a good doc... why not hook up with him instead?
Whatever you decide... I'm backing you with whatever support I can give, my friend.
Marcia
Cindy
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Boceprevir in Null Responders
The results from another study using boceprevir in combination with PegIntron plus ribavirin yielded less promising outcomes. However, this trial was more about establishing the most effective dose of boceprevir, treatment duration, safety issues and if ribavirin was needed to maximize treatment response rates.
In the study there were 357 genotype 1 patients enrolled who were deemed prior null responders – defined as either less than a 2 log10 drop in HCV RNA after 12 weeks of therapy with pegylated interferon/ribavirin therapy or who did not achieve undetectable HCV RNA if treated longer than 12 weeks. There were 7 arms in this study – with or without different doses of boceprevir (100, 200, 400, 800 mg), and with and without ribavirin. This study had a lead-in phase using PegIntron alone.
Bottom Line
It is hard to draw any concrete conclusions because of the small patient population and the many different treatment arms. The group of patients in this study are some of the most difficult to treat and most did not receive the most effective dose of boceprevir. The newly announced phase 3 studies will hopefully answer the question of the role of boceprevir in the retreatment of prior non-responders
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Wondering if telaprevir has results also for non-responders to compare with? Also in the above study couldn't find how many weeks of tx, Also no riba in some arms, different doses of boceprevir, lead-in with Pegintron only, and 7 ARMS, plus a big difference in non-responders and relapsers. I just don't think one can take much out of this.
cando
I should have added, close to the SAME conditions has the above bocprevir study for non-responders.
Non-responders didn't do well no matter what dose of Boceprevir they used or whether they rolled them over to a different arm of the study that used a higher dose....or whether they extended the treatment. The highest SVR was 14%.
This comes from Schering's site.....
Boceprevir in "Null" Nonresponder HCV Patients
Schering-Plough also reported top line results from a completed Phase II study evaluating boceprevir dose response and the need for ribavirin in patients chronically infected with HCV genotype 1 who were nonresponders to previous peginterferon and ribavirin combination therapy (i.e., patients who did not have undetectable HCV-RNA or who did not achieve a 2 log decline in viral load with a minimum of 12 weeks of peginterferon and ribavirin combination therapy). These "null" nonresponders to peginterferon and ribavirin combination therapy represent the most difficult-to-treat patient population. Patients who relapsed following previous HCV therapy (relapsers) were not included in this study.
This study was complex, involving seven different treatment arms. Patients were initially randomized to low doses of boceprevir (100, 200, 400 mg TID) before initiating an 800 mg TID boceprevir arm. Under the study protocol, patients received these boceprevir doses in combination with PEGINTRON (1.5 mcg/kg weekly) with or without REBETOL (800-1400 mg daily) for 24 or 48 weeks, or received PEGINTRON and REBETOL alone as a control. During the ongoing review of the study by the Data Safety Monitoring Board (DSMB), it was recommended that patients in the lower-dose boceprevir arms who demonstrated a substantial antiviral response during treatment cross over to boceprevir 800 mg TID in combination with PEGINTRON and REBETOL for an additional 24 weeks. Patients who did not demonstrate a substantial antiviral response during treatment were discontinued from the study. In addition, patients in the control arm who did not respond to PEGINTRON and REBETOL alone were allowed to cross over to boceprevir 800 mg TID in combination with PEGINTRON and REBETOL. Patients received a maximum of 24 weeks of the optimized regimen (boceprevir 800 mg TID in combination with PEGINTRON and REBETOL). In all, 357 patients were enrolled at centers in the United States and Europe, including 348 patients who received boceprevir at some point in the study.
In this study of well-documented null nonresponders, some patients achieved a sustained virologic response (SVR). Overall, 7-14 percent of patients in the boceprevir crossover arms achieved SVR compared to 2 percent in the control arm. SVR was associated with early virologic response and a longer course of therapy (more than 36 weeks). While potent antiviral activity with boceprevir was seen in the study, with viral loads in some patients decreasing below the limit of detection, viral loads for other patients decreased and then rebounded to baseline levels while on therapy and some patients relapsed following the end of treatment. Several resistant variants were observed in these patients. These HCV variants are similar to those reported after treatment with other HCV protease inhibitors and those previously observed in boceprevir in vitro studies. Whether the results of this study would have been different had all patients been started with the optimized regimen of boceprevir 800 mg TID in combination with PEGINTRON and REBETOL -- and with treatment extending to 48 weeks -- is not known.
"Although interferon nonresponders appear to respond to HCV protease inhibition, it seems that some significant element of interferon response is needed to achieve a sustained virologic response in the majority of these patients," said Eugene R. Schiff, M.D., chief, division of hepatology and director, Center for Liver Disease, University of Miami Miller School of Medicine, and the lead investigator of the study.
Schering-Plough said that in patients with little to no interferon response, alternative treatment strategies are required, and the company will continue to explore regimens containing boceprevir, PEGINTRON and REBETOL in the Phase II setting, using the insights gained in this initial study.
http://www.schering-plough.com/schering_plough/news/release.jsp?releaseID=1064540
RAPID VIROLOGICAL RESPONSE (RVR): the probability of achieving a sustained virological response early in treatment based on a decline in HCV RNA (viral load). The generally accepted timeframe is 4 weeks after starting treatment.
RVR: Rapid Virological Response (4 Week PCR – UND)
UNDETECTABLE (UNQUANTIFIABLE): a viral load (amount of viral RNA) that is below the level of detection of the test being used.
A RVR, meaning HCV RNA levels <15 IU/ml
Division of Infectious Diseases, Department of Medicine, and Division of Virology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 8/05/08
can
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In a 48-week treatment regimen, the SVR rate at 12 weeks after the end of treatment (SVR 12) was 74 percent (ITT) in patients who received 4 weeks of PEGINTRON(TM) (peginterferon alfa-2b) and REBETOL® (ribavirin, USP) prior to the addition of boceprevir (800 mg TID) (P/R lead-in), compared to 38 percent for patients in the control group receiving 48-weeks of PEGINTRON and REBETOL alone.(1-3).
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What ever you decide i wish you the very best guy........
cando
Earlier today you said that your viral load at week 12 was 300 and now you're saying that "at week 12 my load was 475"
So you're saying two different things.
And both Marcia and I had told you that since you didn't clear at 12 weeks....cleared at 24 weeks and you were still clear at 48 weeks....and the virus came back after....that makes you a RELAPSER.
And now, you're asking the same things you were asking before....all over again.
"Well...i know im not a RVR...So what the hell am i..im not a nul responder...im not a non responder"
And the 74% SVR you're looking at again.....is the one for NAIVE patients.
Anyway....take care.
4 week ............300,000
8 wk.................. 3000
12 wk.........................300
actual numbers i have if you want
Does this Boceprevir have results posted anywhere for 1a?
What will it be taken with?
Sorry for the questions. If anyone can help I would apreciate it greatly.
I'm just not ready for another pipe dream.
Still I'm sure it will help most people.
Roche offered Interferon free to me but my doctors at a university hospital told me it would work for 20 percent of 1a patients at best. I would get tons of side effects and that the new meds were going to be out soon and would be oral ones. I also need to lose at least 80 lbs for anything to work right. I'm hoping this will work. If not I'm not going to chase a pipe dream day in and out. Got to enjoy what you have when you have it.
Another thing...I should have never told my girlfriend. I cannot rest, sleep, or do anything without the chick getting involved and wanting me to take the Roche offer. You know I'm not brain dead, my doctors told me my options and would not be able to stop me from going the old route. I'd be stupid to do that because of the side effects. I'm not sure but would it make it less likely to get results from the new meds later? I know the University studies may not want me then. It would be time to pay for it.
If Roche offered you interferon AND ribavirin, that's another story. As for side effects, try getting a treatment for Hep C without them that offers a cure. There isn't one. The amount and kinds of side effects you may get differ for everyone. What is important is your mental ability to be able to commit to treatment and how much you educate yourself on what it involves.
And that 20% figure, what's up with that? On combination therapy with interferon and ribavirin, the cure rate is 40 - 50% and there are quite alot of us here toughing it out to get those odds. Add a good trial drug to that and your odds go up yet more for a treatment naive person who is lucky enough to get the right trial drug.
You may not be brain dead but you don't have your information right just yet. I think you should be talking to other people with Hep C and asking questions other than just your doctors. Either you're not understanding what they're telling you or they're telling you the wrong thing, one or the other, frankly. Because this info you've posted doesn't add up. So maybe that's why your girlfriend is freaking.
And yes, Genotype 1 and 1a are pretty much the same thing. 1a is a subtype of Genotype 1 but for all intents and purposes, basically the same thing.
I am not on any meds.
I have had a biopsy and I am stage 4/4 liver per my GI Doctor.
The University study doctor says 2/4 liver.
I am genotype 1a.
The university doctors are starting a study with new meds in the new year. I have never been treated. I was diagnosed four months ago. The university doctor wants me to do an endoscopy, another blood test, and sonogram befor seeing him in Febuary
Okay-I'm reviewing paperwork here.
This is what it says;
LOBULAR ACTIVITY 2
SEVERE PORTAL FIBROSIS WITH CIRRHOSIS (FIBROSIS4)
(FATTY CHANGE 1)
(MALIGNANCY NOT IDENTIFIED)
------Maglignancy?-CANCER?------
Okay here's more---
HVC RNA (IU/ML) 2140000 H <50 IU/ml
HVC RNA (log IU/ML) 6.33 H <1.70 Log IU/ml)
GENOTYPE 1a
Alpha Fetoprotein Tumor Marker In Range OUT OF RANGE Reference Range
4.8 <6.1 ng/ml
I am also overweight and need to lose at least 50 pounds if not more before I recieve treatment.
I also suspect because of my history with depression is also a factor that the doctors don't want to give me old school medicine.
http://www.clinicaltrials.gov/ct2/show/NCT00708500?term=boceprevir+Trials&rank=3
I also may be participating in the trial in October, I go for screening in a week. I do have one thing against me and that is my biopsy hit its 3 year mark on 9/15. She said they can ask if I can slide since it is so close to the cut off. I am geno 1 naive. My last biopsy was 0 scarring and 1 inflamation (inflammation). I found out about my hep c when I was preagnet 8 years ago. My doctor has told me in the past that I can wait but if I could do treatment I should he sayed my chances at clearing get a little better because I have no scarring and I am not overweight. But I am very skinny so i fear the sides are going to be really bad. I wish that I had a more recent biopsy cause I was drinking for awhile there. Not everyday but some weekends and i was drinking more than one or two, more like 5 or 6. I know i should not have! I am hoping this trial will be a good thing for me.