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Sofo and Riba only for 1b?
Hello all.  Hope everyone is having a peaceful Sunday.  Fairly newish to this forum but not HCV.  I am a 1b, in 95 became INF Intolerant or some say Experienced with Alpha INF which left me with a big laundry list of problems.  So big, I got SSDI immediately.I have not treated since.  Oh yes, & I also have Cryoglobulenemia who I was told by Dr. Gish that it can leave me with permanent memory/brain problems if treated w/INF and can also affect organs.

Anyway Newish here.  Saw my doc last Tues. and told his suggestion is to do 12 weeks of 400 mg Sofi & 1000mg Riba. Which I have not heard or seen so far on any forum.  Usually for 1b it is 24 weeks OR if 12 a 3rd med is added.     So, has anyone here heard of this?  All my docs say I need to treat now due to the Cryo.   I am grateful to all that can respond with feedback.
Peace & Blessings, Renee'Tina
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Yes, Sofosbuvir + Riba for 1b.  1a must add interferon.

Riba is kind of tough on the body but not NEARLY as bad if there's no interferon involved.  Good luck to you!
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Saw my doc last Tues. and told his suggestion is to do 12 weeks of 400 mg Sofi & 1000mg Riba
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As this particular therapy is not yet approved possibly he/she is recommending this as  an 'off-label therapy for you to do

Have you had discussion about possibly waiting  a while longer to do an approved treatment with a comb. of the all-oral drugs in the near future?

There was a small trial done for Geno 1( below)

Sofosbuvir with weight-based ribavirin oral therapy alone has been evaluated in small numbers of patients with HCV genotype 1. In a phase 2 trial of 25 previously untreated patients with all degrees of fibrosis, 68% achieved an SVR when treated with sofosbuvir 400 mg/day plus weight-based ribavirin compared with a 48% SVR in 25 patients treated with sofosbuvir 400 mg plus ribavirin 600 mg daily.[13] The study group included 83% black patients, 23% with advanced liver disease, 70% with HCV genotype 1a, and 48% with a body mass index > 30 kg/m2.

good luck ...

Will


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Oops!  My bad!  Sofosbuvir + Riba approved for genotypes 2 & 3.  It's 1 & 4 that must supplement with Interferon.

However, the FDA approved sofosbuvir in combination with pegylated interferon alfa-2a (Pegasys or PegIntron) and ribavirin for 12 weeks for people with HCV genotypes 1 or 4. *****But it also said that sofosbuvir plus ribavirin for 24 weeks may be considered for genotype 1 patients who are ineligible for or unable to tolerate interferon.*****

http://www.hivandhepatitis.com/hcv-treatment/experimental-hcv-drugs/4438-fda-approves-sofosbuvir-sovaldi-for-hepatitis-c-genotypes-1-2-3-and-4

As willbb said, "Have you had discussion about possibly waiting  a while longer to do an approved treatment with a comb. of the all-oral drugs in the near future?"  Good advice!

HC
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Sovaldi is to be used with ribavirin plus interferon in patients with genotype 1 HCV, which accounts for more than 70 percent of US cases. However, the drug can be considered for use in genotype-1 patients who are ineligible for interferon, whereas analysts had not been expecting an all-oral regimen to be endorsed for this population. Those with the much less common genotype 4 infections will also be treated with the three-drug combination
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HC   ...:)
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Thank you both for responses.  Reason for treatment now is they do not want further progression of the Cryoglobulenemia & frankly Neuropathy pain is debilitating.

Reason for THIS treatment, I have Dr. Notes documenting INF Intolerence (it was severe). What you both wrote was info I need.  Cause of retention issues, I can read & understand studies but then I forget most.  I read a tad of the article you posted Will, thanks. Do either of you know what weight a person should be for 1000 mg & 1200 mg?  there a chart somewhere,  uh was it on that link/article I read just a hair of?

I'm grateful to you both.  Am going to try to put questions together and call the Dr.  Oh, is there anyway I can be notified if a response/comment comes in...through email or must I come here to check?  Also, if I wish to change a New Post title, like this one... Sofosbuvir and RIBA above.               Ok, thanks!
Peace and Blessings,   Renee'
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Dose of ribavirin is weight-based (<75 kg = 1000 mg and ≥75 kg = 1200 mg). The daily dose of ribavirin is administered orally in two divided doses with food. Patients with renal impairment (CrCl ≤ 50 mL/min) require ribavirin dose reduction; refer to ribavirin prescribing information.
SOVALDI in combination with ribavirin for 24 weeks can be considered as a therapeutic option for CHC patients with genotype 1 infection who are ineligible to receive an interferon-based regimen. Treatment decision should be guided by an assessment of the potential benefits and risks for the individual patient


Just keep coming back to check   and possibly best to stay on this thread so  it is easy for members to follow what you have asked and said prev.

However by all means start a new thread if you like.......

Do you have indication of current liver damage ,as this is usually important when discussing with your physician on when to treat  ,,especially in light of you being "tx. experinced  and what would be the most advantageous therapy(given new therapies coming in the relatively near future )

Best...
Will

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HC = HepCat
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