Predicting Response/SVR, etc.

For all of the study and "What are my chances of SVR" wonks --  Ruth J. Corbett's slide presentation at the Clinical Care Options Site is a very comprehensive report that covers everything from explaining the difference between null and non-responders to rvr's, as well as  various studies (short course and extended tx) with estimated odds of predicting treatment. Note that there is a fast forward button at the bottom of the presentation to bypass the fluff. While this presentation covers most of what the Dieterich/Jensen presentation does, the Dieterich/Jensen video presentation "Doc Eye for the Hep Guy" is also very worthwhile.
Free registration required to view these presentations at http://clinicaloptions.com/

-- Jim

[Imagine]

I cringe everytime I see a Predicting Response/SVR. Maybe it is just a case of sour grapes :)

[nygirl7]

You're not alone Imagine - I feel the same way but I don't even have any grapes yet :) NO more wine either ;)

[jmjm530]

I understand your feeling and certainly predicting response is an inexact science. That said, here are the benefits of a virologic monitoring strategy as presented by Ruth Corbett in the presentation, including earlier PCR's (week 4) and certain stopping rules. BTW the name of the presentation is:
"HCV On-Treatment Virologic Monitoring: Impact on Treatment Decisions"

Benefits of virologic monitoring strategy:

1. Limits uncessary exposure to therapy
2. Indentifies treatment failure
3. Justifies early discontinuance in those responding poorly
4. Limits treatment toxicity
5. Limits cost fo those unlikely to respond.
6. Identifies optimal duration of treatment.
7. Provides incentive to continue treatment.

I'll also add that another reason, not mentioned, is that early virologic monitoring affords doctors who are inclined to tweak the treatment drugs when
response is less than desired.

-- Jim

[HCA]

Just watched it!
I suppose it serves it's purpose of establishing a simple treatment protocol for doctors.
The trends on response rates and SVR have become more than evident,but it's good to see them neatly set out.
The irony is that when response rates were lower ,way back when ,Schering-Plough used to tout the drug as an agent that slowed disease progress and facilitated fibrosisis reversal.
Now both of these possible advantages have been written out of the history books.The get with it trend is to pull 'em off treatment quick-thus saving patients unecessary treatment discomfort apparently!

[Imagine]

Jim, all your points are very valid. The SVR part is where it gets tricky.

NYgirl, I hope all your grapes are sweet ones. It sure will be nice one day when all the grapes taste good. I am very happy for you getting through the 72wks. Vacation time?

[jmjm530]

The sad thing is that what you correctly call "simple tx protocols" are probably still unknown to the majority of doctors treating hep c patients. Scary.

[jmjm530]

For better or worse, the marketing boys often get involved in how a drug gets promoted. For better, cause that's how I make a livin' :) Anyway, times have changed, and more alternatives temper the decision to keep going and going and going. You might find the Dieterich/Jensen video a little bit more sophisticated and Dieterich has a nice, wry sense of humor, plus there's a nice little quiz you can take.  Video module is called:  "Doc Eye for the Hep Guy".

Be well,

-- Jim

[mauilady]

Wish I could watch all that but I'm on dialup...  54 kb/sec.... or slower....

[stangshelly]

Thank you for the link. It was very interesting and has made my decision to treat the extended 72 vs 48 for slow responders validated. I hope for the best in svr after tx. I am currently on week 47/72 and I feel good.:)shelly