Boceprevir or Telaprevir?

[Missy114]

Hi everyone! I haven't been on here in a long time, but I am considering starting treatment now and I have a question.  First of all, my doctor recommended Boceprevir over Telaprevir because she says she "thinks" Boceprevir is more effective and reduces Tx time more than Telaprevir does. I know there are a lot of very knowledgable people on here that I can trust so I was wondering what you thought about that.  I honestly have not spent a lot of time researching this topic. It does seem as though Telaprevir is more popular for whatever reason though.

Anyways, quick background on me: I was diagnosed 2 years ago with genotype 1a.  I've probably had the virus for 7-8 years from IV drug use.  I haven't had any labs done in about a year or so, but my VL has always been extremely low, so low once that it was undetectable. The highest it has been is a little over 13,000.  I had a biopsy about a year and a half ago (when I was first considereing Tx) which came back great. No fibrosis.  Because of that I decided to wait for the new meds to come out.

[80mecheng]

Hi Will-I don't have the data other than some online news reports and the link to the treatment guidelines which I have found to fairly useful.

http://www.aasld.org/practiceguidelines/Documents/2011UpdateGenotype1HCVbyAASLD24641.pdf

His practice, which is the largest Gastro group in Greenville SC has all ready had 1 or 2 patients stop treatment with Incivick, one due to a rash and I think the other due to the anal pain.  Could have been a compliance issue with fat intake.

He made his recommendation based on his research and a conference he attended where both companies presented their data.  It should be noted that we are basically less than a year into the usage of either drug so our understanding is incomplete IMO.

[willbb]

All I was doing explaining the doctors rationale for Vic vs Incivick (the subject of this thread) which if you boil it down was concern over the side effects preventing completion of the treatment.  
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Could you please post the data  your doctor possibly took into consideration  that states the diffence in " completing treatment" due to adverse events for both drugs

Thx...
Will

[80mecheng]

Agreed and frankly I am grateful I didn't find I had Hep C till 1 yr before their approval after apparently having the virus for 40 yrs.  Don't think I could do 48 weeks of the prior treatment.  With Vic, the worse side effect has been the anemia.  Be interesting in a year or 2 to see real world data comparing the 2 drugs since the testing population was different.

Been UND since week 8 and have 3 more shots, less than 4 weeks to go.

[hrsepwrguy]

Well just for the record I really have no input on which is better but I can tell you that I had minimal side effects from incivek, no rash, no anemia, I did have nausea which is a side effect of both drugs and I did have the anal discomfort for the first 5-6 wks but once dealt with properly wasn't a problem, I have not needed any rescue drugs or dose reductions.

And I think we already know that both have improved SVR rates for geno 1"s that is why they were approved by the FDA

[80mecheng]

I recognize the 90% response was for those who had RVR and not all achieve it.  All I was doing explaining the doctors rationale for Vic vs Incivick (the subject of this thread) which if you boil it down was concern over the side effects preventing completion of the treatment.  From what I have seen in the press and the experience of those on this site, both are producing good results especially compared to the prior standard treatment.

[hrsepwrguy]

Actually my response is very clear on the stats for tx naive patients, your claim that you had a 90% stat before starting tx is just incorrect, if you care to reread my response you will see that only a certain percentage reach RVR which gives the 88% SVR rate for white patients doin RGT (response guided therapy)

A total of 54% of Caucasian recipients of BOC experienced a rapid virological response (RVR; HCV RNA undetectable, <10-15 IU/mL at week 8, this interval selected because of the 4 week lead-in). By contrast, only 20% of black recipients of BOC experienced an RVR. Regardless of race, among  those patients who became HCV RNA negative at week 8 (
57% in both BOC arms and 17% in SOC arm),