another little silly question

Assuming that you clear the virus after 4, or 8 or 12 weeks, and assumimg that you decide  on your own risk to stop treatment after getting clear - what are the chances that you stay that way (clear) without going to the rest of the treatment?

Any ideas?

Were there any studies about this

[mirceani]

Is this so silly that nobody cares to answer?

[jmjm530]

No questions are silly, in fact silly is not to ask.

Don't know of any studies that match up to treatment durations as short as 4, 8 or 12 weeks, at least for genotype 1's. And while there are stories of someone taking one or two injections, stopping, and then becoming SVR, these are most probably the exceptions and not the rule. If I had to guess, I'd say as a geno 1, your chances of SVR after treating 4 or 8 weeks would be in the 5% range, and becoming SVR after 12 weeks of treatment (assuming UND at week 4) in the 10-20% range. Can't emphasize more that these are pure guesses, nothing more.

All the best,

-- Jim

[kcrandy]

silly is a kind word to say the lest!

believe me if there was a way to stop taking the tx advice after becoming und we would all be doing it.  if you read some of the previous threads in this group and the other group you will see that even people who have struggled just to get thru the complete prescribed tx and have cleared as early as 4 weeks have relapsed.  the virus had come back. from what i know there is no easy way to beat this virus with one or two shots,  maybe in the future it may be possible,  and i mean FUTURE.  i hope you continue as advised by tx doc and keep coming back here and there are many in this group who will be here to try and help you thru the full tx process.

[buzz01]

Great question. Unfortunately, there's only published data about geno types 2/3, not geno 1.

I pulled this from http://hepcadvocate.org/

"Shorter Interferon/Ribavirin Course Effective for Chronic Hepatitis C Types 2 & 3
by Peggy Peck

Among patients with chronic hepatitis C (HCV) genotype 2 or 3 infection, 24 weeks of PEG-interferon alfa-2b plus ribavirin treatment is as effective as a 48-week regimen, according to results of a study of presented at the 54th Annual Meeting of the American Association for the Study of Liver Diseases.

The shorter course has the added bonuses of lower cost and fewer side effects.

"Look at the response rates: 81% of patients achieved sustained viral response with just 24 weeks of treatment," said principle investigator Dr. Stefan Zeuzem of Saarland University Hospital, Homburg, Germany.

Two hundred twenty-four HCV patients (42 genotype 2, 182 genotype 3) were enrolled in the study in which they were treated with PEG-interferon alfa-2B 1.5g/kg plus ribavirin 800-1000 mg/day. The results were compared with those achieved in historical controls treated with the same combination for 48 weeks.

In an interview with Reuters Health, Dr. Zeuzem said that HCV treatment is often compromised by "the side-effects that cause patients to reduce dose or discontinue therapy. But if you look at the historical data from studies of 48 weeks, what we see is a response at 24 weeks and then the side effects become evident during the second half of treatment. By shortening treatment, we are significantly reducing the depression, fatigue, headaches—the side effects that make the treatment so difficult."

The end-of-treatment response rate with the shortened course was 94% (versus 95% among historical controls), and the estimated sustained virologic response rate at 48 weeks was 84%.

Dr. Zeuzem also pointed out that "standard 48-week treatment costs about 20,000 euros, so 24-weeks costs about 10,000 euros." He predicted similar reductions in cost in the U.S.

"Twenty-four weeks should now be considered the standard for patients with genotype 2 and 3," he said.

Dr. Zeuzem noted that the shortened treatment regimen is much better tolerated by patients as evidenced by improved compliance: only 5% of patients discontinued treatment, while the discontinuation rate in historical controls is 14%. Likewise, 22% of patients required dose reduction during the 24 weeks, while doses were reduced in 49% of historical controls.

The study was funded by Schering-Plough Research Institute, Kenilworth, NJ."

[buzz01]

OH SHI#!  Look at what I just found!

March 6th, 2007


PEGASYS(R) Gets European Approval for a Shorter Treatment Duration for Some Genotype 1 and 4 Hepatitis C Patients who Show a Rapid Response to Therapy
http://www.prnewswire.co.uk

- Shorter, Simplified Treatment Option May Encourage More Patients to Seek Treatment

Some hepatitis C patients with difficult-to-treat HCV genotype 1 who respond quickly to treatment with a combination of PEGASYS(R) (pegylated interferon alfa-2a (40KD)) plus COPEGUS(R) (ribavirin) can benefit from a shorter and simplified course of therapy, following Thursday's Commission decision. With the new approval, a subset of patients with genotypes 1 and 4 HCV who achieve rapid viral response can now receive a shortened, 24-week duration of treatment with Roche's PEGASYS plus COPEGUS. This is half the normal treatment duration.

Shorter, Simplified Treatment Shows Excellent Chance for a Cure
The EU approval is based on data from two pivotal clinical trials for PEGASYS plus COPEGUS.(1,2) Results from these trials show that among patients who achieved a rapid viral response (undetectable viral load at week 4) in the first month of treatment up to 93 per cent of patients with genotype 1 HCV with a low pre-treatment viral load and 83 per cent of patients with genotype 4 were cured following only 24 weeks of therapy - a similar cure rate to that seen following 48 weeks of therapy.(3)

"This is excellent news for patients with hepatitis C," said Dr Peter Ferenci, Professor of the Department of Internal Medicine IV, Gastroenterology and Hepatology, at the University of Vienna, Austria. "This means that patients can find out within one month of starting therapy if they have an excellent chance of being cured and can benefit from a shortened treatment duration. This is likely to encourage patients to seek treatment and motivate them to stay on therapy."

New Recommendations for Treatment
A shorter, 24-week course with PEGASYS plus COPEGUS is now an option for the following patients:(4)

Genotype 1 HCV with a low pre-treatment viral load (defined as <800,000 IU/mL) and an undetectable viral load at weeks 4 and 24;
Genotype 4 HCV regardless of pre-treatment viral load and an undetectable viral load at weeks 4 and 24.
"This licence change reflects Roche's commitment to finding better treatment solutions for patients with HCV by improving treatment with existing therapies and developing new medicines to treat hepatitis C," said Claire Steers, PEGASYS Lifecycle Leader at Roche in Basel, Switzerland. "Roche is committed to finding solutions for a broad range of hepatitis C patients by continuing to simplify treatment with PEGASYS."

About Hepatitis C
Hepatitis C, the most common chronic blood-borne infection, is transmitted primarily through blood or blood products. Hepatitis C chronically infects 180 million people worldwide, with an additional three to four million people newly infected each year.(5,6) It is a leading cause of cirrhosis, liver cancer and liver failure.

About PEGASYS
PEGASYS, the market leader worldwide in hepatitis C therapy, provides significant benefit over conventional interferon therapy in HCV patients of all genotypes. The benefits of PEGASYS are derived from its large 40 kilodalton (KD) branched-chain polyethylene glycol (PEG) construction, which allows for sustained drug levels over the course of a full week. PEGASYS also distributes more readily to the liver (the primary site of infection) than conventional interferon. PEGASYS is the only pegylated interferon available as a ready-to-administer solution. Each weekly subcutaneous injection contains 180 microg of pegylated interferon alfa-2a (40KD), which is the approved dose for all patients, regardless of body weight.

About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation, and a market leader in virology. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (www.roche.com).

All trademarks used or mentioned in this release are legally protected.

Film footage is available for broadcast journalists from The NewsMarket at www.thenewsmarket.com. Video is compressed in MPEG2 and is available for download to your FTP server.

References
1. Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347(13):975-82.
2. Hadziyannis SJ, Sette H, Jr., Morgan TR, et al. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140(5):346-55.
3. Data on file, Roche 2006.
4. PEGASYS(R) EMEA Summary of Product Characteristics. www.emea.eu.int.
5. Initiative for Vaccine Research, Viral Cancers, Hepatitis C. World Health Organization, 2006. (Accessed July 24, 2006, at http://www.who.int/vaccine_research
/diseases/viral_cancers /en/index2.html.)
6. Global surveillance and control of hepatitis C. Report of a WHO Consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium. J Viral Hepat 1999;6(1):35-47.

Distributed by PR Newswire on behalf of Roche Pharmaceuticals

[kcrandy]

sounds like promising stuff. i would tend to agree that this study will apply to small amount of geno1 types.  i pray that there would be a day that one shot would take care of those who have hcv, and one shot or vaccination for everyone else.

it will be interesting to see how that study goes

[orleans]

Why do ya'll reckon you don't hear more about this? How very tempting for RVRs. To dream of only having 18 remaining weeks as opposed to 42 weeks!!! Do I even DARE to think it? jerry