Aa
Boceprevir or Telaprevir?
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.
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.
I took Incivek and I would do it again (but only if I had to, lol).
Incivek does have more rashes and it also has some anal problems in some people. Both Incivek and Victrellis can cause anemia but Victrelis seems to cause anemia in a higher percentage of people than does Incivek. They both have a lot of side effects so neither is a picnic, but generally, unless one gets life threatening side effects, both are doable (is that a word, lol).
One really good thing is Incivek is done in 12 weeks time (and I found that a big plus). A person takes Victrellis for 24 weeks or longer.
Incivek is expensive for 12 weeks of treatment. Victrelis costs less if one does the 28 weeks of treatment but the costs are similar if one has to treat longer on Victrellis.
Some insurance companies are not as good as others. Having a good doctor who has a good team and who fills out the proper insurance approval paperwork on time is imperative. Having a specialty pharmacy that takes care of the medication approvals and arrangements helps immensely.
I have actually not had top do a thing about insurance other than to give the insurance information to the doctor and clinic. The doctor and his team did the rest by filling out the paperwork and contacting the specialty pharmacy. The specialty pharmacy contacts the ins. co. and gets all of the approvals a couple of weeks in advance and they stay on top of it. I receive my box of meds via United Parcel a week before I need them so I never run out.
In the end, since the SVR rates seem to generally be similar, the decision concerning which to use is a personal decision that a person makes based on his/her own situation and circumstances. I know you are picking our brains for experience and information and I think it is helpful for people to offer their knowledge and experience.
I wish you the best whichever med you decide to use.
Incivek does have more rashes and it also has some anal problems in some people. Both Incivek and Victrellis can cause anemia but Victrelis seems to cause anemia in a higher percentage of people than does Incivek. They both have a lot of side effects so neither is a picnic, but generally, unless one gets life threatening side effects, both are doable (is that a word, lol).
One really good thing is Incivek is done in 12 weeks time (and I found that a big plus). A person takes Victrellis for 24 weeks or longer.
Incivek is expensive for 12 weeks of treatment. Victrelis costs less if one does the 28 weeks of treatment but the costs are similar if one has to treat longer on Victrellis.
Some insurance companies are not as good as others. Having a good doctor who has a good team and who fills out the proper insurance approval paperwork on time is imperative. Having a specialty pharmacy that takes care of the medication approvals and arrangements helps immensely.
I have actually not had top do a thing about insurance other than to give the insurance information to the doctor and clinic. The doctor and his team did the rest by filling out the paperwork and contacting the specialty pharmacy. The specialty pharmacy contacts the ins. co. and gets all of the approvals a couple of weeks in advance and they stay on top of it. I receive my box of meds via United Parcel a week before I need them so I never run out.
In the end, since the SVR rates seem to generally be similar, the decision concerning which to use is a personal decision that a person makes based on his/her own situation and circumstances. I know you are picking our brains for experience and information and I think it is helpful for people to offer their knowledge and experience.
I wish you the best whichever med you decide to use.
Thanks for the advice but I have already finished with telaprevir and am in wk 29 of treatment and undetectable.
I am very sorry to hear about your husbands situation though and wish you all the best moving foward
I am very sorry to hear about your husbands situation though and wish you all the best moving foward
He recommended Vic for me for the following reasons:
1)with either, once you stop they currently do not think you can redo like prior Pega/Riba treatment alone.
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Why would your doctor recommend Vic for this reason when both protease's resistance issues are still unknown???
2)A few on here actually ended up in the hospital as a result and stopped treatment.
----------------
Your doctor recommended Vic because some MH members ended up in the hospital??
3) Merck has a support system called Be In Charge with nurses available 24-7 for questions and concerns. I have used them and they have been helpful.
------------------------------
Why would your doctor be concerned with a drug companies support line..they all have 24 hr lines???
4)I am Geno type 1, first treatment, white (blacks are less responsive to treatment in general) and modest liver damage. The success rate is about 90% for my conditions.
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Your doctor knew you would RVR before you started??---
I don't see how any knowledgeable doctor experienced in the treatment of HCV could make any recommendations based on what you have told us..
Missy114:
Both of these drugs are excellent ..and this link gives DR.Shiffman's(noted Hepatologist) take on both as an adjunct to what hrsepwrguy has copied above.
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02718.x/full
Good luck with your decision..
Will
1)with either, once you stop they currently do not think you can redo like prior Pega/Riba treatment alone.
-------------------------
Why would your doctor recommend Vic for this reason when both protease's resistance issues are still unknown???
2)A few on here actually ended up in the hospital as a result and stopped treatment.
----------------
Your doctor recommended Vic because some MH members ended up in the hospital??
3) Merck has a support system called Be In Charge with nurses available 24-7 for questions and concerns. I have used them and they have been helpful.
------------------------------
Why would your doctor be concerned with a drug companies support line..they all have 24 hr lines???
4)I am Geno type 1, first treatment, white (blacks are less responsive to treatment in general) and modest liver damage. The success rate is about 90% for my conditions.
--------------------------------------------------------
Your doctor knew you would RVR before you started??---
I don't see how any knowledgeable doctor experienced in the treatment of HCV could make any recommendations based on what you have told us..
Missy114:
Both of these drugs are excellent ..and this link gives DR.Shiffman's(noted Hepatologist) take on both as an adjunct to what hrsepwrguy has copied above.
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02718.x/full
Good luck with your decision..
Will
Don't take telepravil. Its too expensive and from experience the insurance companies won't send it to you in time. Iy cost my husband his life. Go with the other. Also your body can build immunity so you want to do it hard and quick!
Patients Who Have Never Received Therapy
(Treatment-Naı¨ve Patients) Boceprevir. The SPRINT-2 trial
The SVR rates among Caucasian patients were 67% in the RGT, 69% in the fixed duration, and 41% in the SOC arms, respectively.12 In black
patients, the SVR rates were 42% in the RGT, 53% in the fixed duration, and 23% in the SOC arms, respectively (Fig. 1).12 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), the SVR rates were 88% in the RGT arm, 90% in the fixed duration arm and 85% in the arm treated
by SOC, compared to SVR rates of 36%, 40%, and 30%, respectively, if HCV RNA remained detectable at week 8
http://www.aasld.org/practiceguidelines/Documents/2011UpdateGenotype1HCVbyAASLD24641.pdf
(Treatment-Naı¨ve Patients) Boceprevir. The SPRINT-2 trial
The SVR rates among Caucasian patients were 67% in the RGT, 69% in the fixed duration, and 41% in the SOC arms, respectively.12 In black
patients, the SVR rates were 42% in the RGT, 53% in the fixed duration, and 23% in the SOC arms, respectively (Fig. 1).12 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), the SVR rates were 88% in the RGT arm, 90% in the fixed duration arm and 85% in the arm treated
by SOC, compared to SVR rates of 36%, 40%, and 30%, respectively, if HCV RNA remained detectable at week 8
http://www.aasld.org/practiceguidelines/Documents/2011UpdateGenotype1HCVbyAASLD24641.pdf
The success rate is about 90% for my conditions.
That success rate is based on the fact that you were UND at wk 8 not your conditions.
That success rate is based on the fact that you were UND at wk 8 not your conditions.
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