Victrelis: Length of Tx

Does anybody know why the Victrelis (and Incivek) protocol is to treat for 28 weeks (24 with Incivek) if we are clear at 8, 12 an 24 weeks, and Tx naive, but to treat for longer, if cirrhotic, or had a prior relapse, on soc, etc?
   Why not treat everybody for 48 weeks, just to be safe? Is it a matter of cost and side effects, coupled with testing stats, of these populations clearing?
   I would just feel more safe and secure, to be Txing a little longer, ya know?
I want to do this right, the first time~

[Idyllic]

I always thought the Vic was four weeks longer because of the lead in but hey ~ that is a guess. As far as treatment duration with Incivek in the Illuminate trial a (study included 540 HCV genotype. 1 treatment-naïve patients) the aim of the study was to find out if there was added benefit in extending the total treatment duration from 24 weeks to 48 weeks.

Based on the data there was no benefit seen in extending the treatment duration from 24 to 48 weeks.

The stats are easy enough to follow in this link:
http://tinyurl.com/clah489
It is read only.

If that does not work hrsepwrguy pretty much summarizes the data in his posts (even though the OP has a different question)

http://www.medhelp.org/posts/Hepatitis-C/does-triple-therapy-with-incevet-guarantee-undect-at-4-weekd/show/1741731

So even though you feel like you may be better off treating longer the studies for treatment naive people show this is not necessarily the case.

★★This is for Incivek however. I am betting there is a similar study with the Vic.

[BoceprevirGal]

  Thanks Idyllic, yes, you are prob right, that there is a similar study for the Victrelis, it would only make sense, and thanks or breaking it down for me~
   So...there is no benefit..that would make sense.
But 540 people..that isn't a very big study.  I would feel better if there had been a study with, say..2000 people.  
   The act that these Pi's have only been approved
for a little over a year, does worry me sometimes. I tried to ind a recent study, of people who have treated on these PI's for half a year, this year, but I am guessing the results havent come in, although i thought they were supposed to, around June of this year.
   Still, I have read of more successes then the other scenario.  I kind of wish they wouldn't use that term, "failure", when they refer to Tx, though. Everybody that has gone thru this, and done their best, is a winner, in my opinion.

[Idyllic]

It's late maybe other people will have insight later on. I have a feeling that in oh, say five years from now or so there will be so much more known about these PI's.  I mean so much can happen with HCV and these meds. To me in the end we are all taking a leap of faith.

But truly Bo (I can't believe I of all people am going to say this) you have to quit worrying and start believing. The odds are very good where you are concerned.

[frijole]

The treatment time - 28 for VIc vs 24 for Inc is precisely because of the 4-week lead in for Victrelis.  I think when they have a patient who seemed to have an interferon resistence in prior treatments they are more likely to want the 4-week lead in.

As far as "why not treat everyone for 48" -- this 24/28 week tx is the best thing that has ever come around for geno 1s.  I am so happy for everyone about to do short duration. All  I can say that 48 with Vic is not easy and I don't wish it upon anyone who can get away with shorter time.
bean

[BoceprevirGal]

Yes, the shorter time is much better, 48 weeks is so hard on the body, with these chemicals.
  I am not too worried about EOT in less then 3
weeks...I am more preparing myself for the change in my life (routine). What will I do, now that I dont have to pop meds all the time...I have thrown so much energy into doing this, kind of like an athletic event.
  I will be unsettled, while I wait, for the 3 and then 6 months, for the vl test, and I am definitely going to continue going to my home HCV support group~

[orphanedhawk]

I have to ditto the remarks about why would anyone take these strong drugs one day longer than is needed ? There is already enough potential for long term side effects.

There is no need to assume how you will feel after you're done, you haven't gotten there yet.
Try living in the moment :)

[frijole]

What will I do, now that I dont have to pop meds all the time...I have thrown so much energy into doing this, kind of like an athletic event.

ha ha ha -- you get the Gold! (I have Olympic fever)

Bo, not having to take those pills -- that is the best thing so far.  I have been off meds for 7 days now.  The first 3 were so pleasurable.  Every pill time I told my hubby, I am not taking a pill.  Once he even said, do you have to eat now, do you have to take a ........  oh.  Right now I think I am dealing with detoxing.  I have felt awful all week.

I need to get moving and am still not motivated for that.  I think a few trips around the block - well, maybe one - will be good next week.  This week I was just enjoying sleeping an extra half.