So its approved for genotype 1 what about a,b,c??

[boxerbabs]

Well I know theres alot of waiting for this time!! But like I titled what about people that are genotype 1a like I am!? Im new to this site joined about a week or so ago.But everybody seems very nice & helpful! With this approvel its kinda scarieee to.My Dr/CNA said they wanted me to wait until this drug was approved & start my tx with it. I've to been reading on this drug & im not to sure about it?? Best of Luck to those who have been waiting on this tx !!! Cant wait to see what I read now!!! thanks boxerbabs

[Tkflex]

Hi I m new to talking about my hepc I am a geno 3a u wouldn't happen to know success rates for me with my type. I am 30 had a biop 2 years ago showed min scarring, I am thinkin It's time to treat, although I heard there r trails involving only oral meds only available through study or trial? Any advice?

[evangelin]

-Aaron,
Thanks for all your good information.  It backs up our almost firm decision to wait it out until a better boat comes along.  Joe is a 1B but he is has stable cirrhosis and the best we ever got out of just interferon/riba combo was an almost partial response.  Not a total null but under par for a partial.
He continues to take Hep Tech and feels very decent.  The owner of the company recently posted his latest fibroscan results and they are extremely encouraging.  He went from cirrhosis to barely above normal fibrosis score.  I don't understand much about fibroscans but someone explained it to me by telling me the score of a normal, healthy, uninfected person , and Todd's was just barely higher.  His diet is more perfected than Joe's and he is younger.  Todd actually has both hep. B and C and you would think that would be worse but I don't know much about that.   I've never persuaded Joe to exercise but he isn't what you'd call inactive now that he feels better. Todd is a fitness expert so naturally he is really in to exercise...Joe, not so much.  I don't know if we can get results as good or not.  We also don't have access to fibroscans so we only have how he feels and labs every 6 months to compare to.  There were improvements on his las labs and nothing worsened.  He will get them again in July.  Time will tell.
Thanks again for the information you posted.  I think I'd seen it all in the past but I needed a review of why we should probably wait.
Ev

[Aaron57]

The data above is from several different sources .. If you are referring to the success ratio's for 1a vs.1b and the differences in chances of mutations and/or resistance issues .... heres a few links to get you started..
1 link is to CCO , Clinical Care Options (free registration) if not already registered , an excellent data and learning resource.

http://www.natap.org/2011/EASL/EASL_14.htm

http://www.clinicaloptions.com/Hepatitis/Conference%20Coverage/Berlin%202011/Tracks/From%20Podium%20to%20Practice/Capsules/8.aspx

http://hepatitiscnewdrugs.blogspot.com/2011/04/drug-resistant-variants-emerge-in-most.html

Mike , there is a fair amount of published clinical data on this subject now .. anything I missed feel free to ask ...

[mikesimon]

Would you post the link?

Mike

[Aaron57]

Susie, very well could be a generic question .. it's sometimes hard to know what the poster means .. since she said the following, I took it to mean what about result differences for a,b,c,

"But like I titled what about people that are genotype 1a like I am!?" "I've to been reading on this drug & im not to sure about it??"

Guess we'll have to wait and see if she can clear it up for us ....

There is a fair amount of published data on success ratio's and also the risk of virus mutation/resistance for both new drugs ..

Either way ,folks considering the DAA's should spend the time and become informed/educated about Tela or Boce before treating ..

Cheers

[SusieS2010]

Thanks for posting that extra information. I had been looking for that. However, I don't think boxerbabs was asking that particular question. I read it that she thought that there was a "plain" genotype 1 and was asking what about geno 1a, etc. At any rate I really appreciate what you posted. Thanks again.

[Aaron57]

Your 1a vs. 1b  is a very good question that needs further study ... IMO ...

There is, and, possibly just as important or maybe more so ....  also an important ratio difference in 1a and 1b concerning Telaprevir resistance and mutant strains in Telaprevir treatment failure subjects.



Main Findings
Of 388 patients without SVR and with population sequencing data, 289 (74%) had resistant variants at time of treatment failure
Follow-up data available for 255 patients
Median follow-up: 10 months (range: 2 weeks - 16 months)
During follow-up, resistant variants no longer detectable in 60% of patients
Within 1 year after treatment failure, 71% of patients had wild-type virus; by 16 months, 96% had wild-type virus
Median time to wild type: 7 months (95% confidence interval [CI]: 5-8)

Probability of having resistant variants at treatment failure and rate of loss of resistant variants after treatment discontinuation both differed according to HCV genotype 1 subtype

Patients with 1b subtype less likely to have resistant variants at treatment failure and reverted to wild type more quickly than patients with 1a subtype (P < .0001)
Within 1 year, 60% vs 98% of genotype 1a and 1b patients, respectively, had wild-type virus




The subject of 1a vs. 1b using Tela has been studied for Tx experienced and cirrhotic patients. For Tx naive however .. data seems sparse ..


Lead-In, 1a vs 1b, cirrhotics)
EASL: REALIZE Trial Final Results: Telaprevir-based Regimen for Genotype 1 Hepatitis C Virus Infection in Patients with Prior Null Response, Partial Response or Relapse to Peginterferon/Ribavirin - (04/01/11)

- 85% SVR for prior relapsers; 56% for prior partial responders; 31% for prior null responders with 48 weeks treatment (12 weeks telaprevir, 48 weeks peg/rbv)
- Lead-In - in this study a 4 week lead-in with peg/rbv alone then adding telaprevir showed no benefit compared to starting all 3 drugs together in terms of SVR.

- 1a vs 1b genotype: for prior null responders - 27% SVR for 1a vs 37% for 1b; for partial prior responders - 47% for 1a vs 68% for 1b; for relapsers no real difference - 84% for 1a vs 88% for 1b.

- cirrhotics did not do as well if they were prior partial responders or null responders but did the same if they were prior relapsers. Partial prior responders: 72% SVR if no or minimal fibrosis; 56% SVR with bridging cirrhosis; 34% if cirrhotic. For prior null responders 41% with no or minimal fibrosis & 39% with bridging fibrosis had SVR compared with 14% SVR for those with cirrhosis.