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To teplavir or bocrevir
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To teplavir or bocrevir

Can I ask anyone out there that may know,are there statistic's wich say wich protese inhibitor is easier to handle?
In Aust. we have a choice of Teplavir or bocrevir I jope I'm spelling them correctly,I would appreciate any and every opinion I can get Thanks Folks
18 Comments Post a Comment
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317787_tn?1373214989
Hello, I am sure others will be here and help you out  In the meantime I would check on the side effects of both.
I did the Incivek tx, due to the level of damage I have it was a very hard tx for me.  I did 24 weeks, finished 7 months ago and am SVR.  I am very happy.  At the same time, I did not have to work, I don't think I could have worked
I picked the Incivek because all I had heard about for years was Incivek (VX950) and had not really heard much about the Victrellis.

I have read others comments re: Victrellis and it doesn't seem to be as bad.  Of course that is just my perception, reading everyone's posts for the past year.
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1840891_tn?1383280315
I have the same story as Dee, except that I just finished treatment 2 weeks ago and won't know for quite a while if I'm SVR or not. I also have the same perception that the people on Boceprivir had slightly less side effects, but I'm not sure. Will this be your first treatment? Some people have based their choice partially on their response to earlier treatment with interferon - but I don't know if that is a good basis for the decision or not. My own hepatologist asked me which I preferred, but I knew very little about the two options and had no preference, so instead I watched him making the decision for me. The factors that i was aware of him taking into consideration were the fact that I had responded very slowly to interferon during a previous tx, and that I had not gotten any rash during previous tx with ribavirin. The Incivek tx involves adding Incivek for just the first 12 weeks but carries a significant risk of very bad rash. The Boceprivir tx starts with just the interferon and ribavirin, then adds Boceprivir after x (I forgot the number) of weeks and continues it throughout the remainder of tx. I hope someone who treated with it will come on and talk about those side effects. Good luck!
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Avatar_f_tn
  I chose Boceprevir, I let my Doctor decide, before I was as educated on the subject, as I am now.
  One of the biggest problems, concerning Triple Treatment, is a common side effect called "hemolytic anemia".  If you are on Incivek, then you only have to be on it for the first 12 weeks, and then, wether you Treat for 24 wks, or 48 wks, (this decision will be based on if you are "Treatment Naive", meaning, never tried treating before) and how fast your body is responding to the meds, and how soon you become "undetectable" (no more virus)
   Now...if you pick Boceprevir, you start with a "4 week lead in" of just a weekly Interferon shot, and ribaviran pills, so it starts out easy! (with Incivek, all 3 meds start at once, which is much tougher)
   After 4 wks of the first 2 meds, if you clear your virus (undetected in blood draw) then you only have to Treat for 28 wks, like I did.
   The problem with Boceprevir is: if it ends up you have a slower response (or have a history of prior relapse) than you will have to be on all 3 meds for 44 weeks, which would be very hard to deal with, if you ended up with the anemia!
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3997096_tn?1349321461
This will be My first shot at any treatment,So this is all new to me But the gastroenerologist,runs the clinic he is my Dr,and I do trust him,thank you for your input.
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3997096_tn?1349321461
Thanks Dee1956 It helps to know how some people approch trearment.
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3997096_tn?1349321461
Well I've been sun burned before but miricales happen,and I have to give it a chance,It sounds like hep C does'nt like incivek,mabye it's worth the pain.
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1856046_tn?1330240845
I picked Telaprevir because I have cirrhosis and liked the numbers from their trial and I am a 3x relapser.

Also, I did a 4 week lead-in (peg-inf + ribivirin only which is non-standard), for two reasons:
1st, since I had to stop my last tx (with Infergen which is non-pegylated and you do 1 shot per day) due to low platelets of 6k, I wanted to see what the effect of the pegylated version had on my platelets before starting on the PI (protease inhibitor). Once you start a PI, if you have to stop, you can't re-start them for a long time. I also started on Promacta which is a platelet stimulator, 2 months before starting the tx to help keep my platelets up and they haven't gotten lower than 50k through 27 weeks.
2nd - the results from the C216 REALIZE trial (link below) showed an SVR rate for relapser cirrhotics as 82% without the lead-in and 86% with the lead-in. They said this was "not statistically significant" but I told my hepa that if I was in the extra 4% who SVR'd, that it would be pretty significant to me and she agreed! This study only had 145 prior relapser cirrhotics, but since I was going to do the tx anyway, I liked these numbers!

I was lucky that the side effects were minimal for me, I started getting anemia so my Ribavirin was cut in half: 1200 down to 600-mg/day) during the 12 weeks of the PI. Studies show that cutting the riba in half during the PI had no effect on SVR rates and was preferable to Procrit. I was back to 1200 mg/day within 3 weeks after finishing the PI and my Hgb has not gotten lower than 11 during tx. The worst part for me was having to eat 20 grams of fat before every dose, 3x/day. I had a hard time especially at the 6am dose as the PI nauseated me pretty badly and NOTHING sounded good to eat. I ended up eating hot dogs (which I don't normally eat) for breakfast because I was able to wash them down with whole milk. I also was off work and on disability for 16 weeks during the PI and 4 weeks after. I couldn't have worked during it unless I had to.

This is only my experience and I urge you to get more views before deciding.

link to trial results:
www.fda.gov/downloads/AdvisoryCommittees/.../UCM252562.pdf

Good luck and you are in the right place on this forum!
Chris
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Avatar_m_tn
As you will see each of us are different, I picked Victrelis (boceprevir) for about the same reason as Big daddy picked telaprevir, being cirrhotic the numbers to me looked better plus there were several here that was having better luck with it. And it seems from the results here I would pick it again if I needed to. Also the side effects seem to be easier.


Frijole posted this in her thread....... "Later, much later, the PA told me they are mostly using the INC for naive and the VIC for relapsers or cirrhotics. Worked for me -- what can I say."


All that said they are both good drugs, being your cirrhotic you need to treat for 48 weeks with either. The most important thing is make sure you and your doctor agree on how you will treat any side effects and hopefully before any dose reductions are needed. Myself I think cirrhotics really need to try to stay on 100% of all meds as much as possible
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Avatar_f_tn
My husband's hepatologist said either was fine with her.  About half of her patients were treating with Incivek and half with Victrelis.  My husband chose Incivek because he had some problems with anemia during her first two treatments, and we had read that anemia tends to be a bigger concern with Victrelis than with Incivek.  He had moderate side effects with Incivek (rash, diarrhea, anal/rectal pain/bleeding, and fatigue), but felt much better after the 12 weeks of Incivek were completed.
Advocate1955
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2114467_tn?1358213856
Hi. I am nearing EOT with boceprevir. I chose this PI  over the other because I am a swimmer and I feared the rash. Also, where I work there was no way I could run to the bathroom at will.
The hardest part with th boceprevir is the rigorous 8 hour, pill popping, schedule. Me, a little sleep deprived. If I had to choose over again, and didn't have to work, I would do the incivek.
Best wishes to you,
C
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766573_tn?1365170066
As a prior partial responder the % of SVR was slightly more promising with Incivek (Teleprevir) compared to the Victrelis (Boceprevir).  Although the 20 grams of fat required with each dose of Teleprevir was difficult to tolerate at times I can't really complain.  It's a funky drug so I got the head trip that comes with it (and goes away the day after you quit taking it) but I did not experience the other harsh side effects associated with it.

Don't underestimate the Peg and the Riba though. My anaemia and skin irritations (from the Riba) kicked in after the protease inhibitor. Ditto with the decreased absolute neutrophil count (thanks to the Peg).
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766573_tn?1365170066
Oh I should add that I am at the 80% mark of treatment. :)
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3997096_tn?1349321461
Thank you for your opinion,as my Dr,asked me about skin rashes in my life
so I am asuming he's pretty sold on Teplavir,hope you do well you look like you have a wonderful family to support you,
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Avatar_m_tn
Everybody will have their own opinion on what might be better based possibly somewhat on personal bias.

I have linked below an article you might be interested in written by two noted Hepatologists on comparing both the protease Inhibitors when considering which therap

Best to you..

Will


http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02718.x/full

Although the SVR rates observed with boceprevir and telaprevir are quite similar both globally and within sub-populations, the treatment algorithms for the two agents are unique. The decision of which protease inhibitor to use should assess several factors including the treatment scheme, duration of therapy, adverse event profile, cost and the likelihood of achieving a RVR. The latter is highly dependent upon IFN sensitivity and the IL28B genotype.
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Avatar_m_tn
Don't think I would even consider Victrellis (Boceprevir).  I believe you still have to maintain the every 8 hours dosing and eating.   That is a lot more disruptive than you might initially imagine.  The think is teleprevir is only for 12 weeks and boceprevir is much longer.  It is a rough time and 12 weeks is about all I could stand.
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3867523_tn?1348953285
So what is the funky head trip?  Depression, etc?  Thanks,  Garry
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3997096_tn?1349321461
Thanks to all who responded to my question of telepravir orBocepravir
                                                  God bless you all
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163305_tn?1333672171
You might want to look at this site:
http://tripletherapyforhepatitisc.com
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