Starting Sovaldi - Prior relapser

[48weeks]

Just got a call from my hepatologist's office to start the process of getting me started on Sovaldi.  I am a gt 1a, twice non-responder to Int+Rib and I relapsed after 48 weeks of triple therapy with Incivek. Anyone know what the cure rate for this treatment is for a relapser?

[MagTX]

It is estimated that the response rate in patients who previously failed pegylated interferon and ribavirin therapy will approximate the observed response rate in NEUTRINO subjects with multiple baseline factors traditionally associated with a lower response to interferon-based treatment (Table 9). The SVR rate in the NEUTRINO trial.

http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/sovaldi/sovaldi_pi.pdf

[can-do-man]

Not sure your doctors reason as it seems clear interferon does not work for you. Though I do wish you the best.

HCV Genotype 1

The ELECTRON team then proceeded to test sofosbuvir in people with more difficult-to-treat HCV genotype 1, both treatment-naive and null responders to previous interferon-based therapy. They looked first at the same combination of 400 mg sofosbuvir once-daily plus 1000-1200 mg ribavirin for 12 weeks.

As Gane reported at this year's Retrovirus conference, although all participants saw a rapid decline in HCV RNA and had undetectable viral load at the end of the 12-week course of treatment, almost all genotype 1 prior null responders relapsed soon thereafter, resulting in a very low cure rate.

Given that sofosbuvir plus ribavirin as a dual regimen is not adequate for this more difficult-to-treat patient population, researchers then asked whether adding a second direct-acting agent could increase cure rates.

http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3860-aasld-2012-sofosbuvirgs-5885ribavirin-shows-high-early-response-rates-for-genotype-1-hcv

[willbb]

Having the same result with an INF based therapy 3 times and once with a protease added(Incivek)  I also wonder what your physician's logic is.

Have you discussed with him/her possibly waiting until the virus can be attacked  from multiple fronts (ie two or more of the all oral drugs) and leave the failed INf out of the mix?

best of luck..
Will

[MagTX]

I agree can-do.  Seems the 3 DAA's are working the best for the geno 1's null responders and for those who previously relapsed.

[willbb]

Also Has the physician had any discussion with you about possible resistance issues developing .....meaning if you failed the NS3 /4 drug ( Incivek)  because  partially of the insensitivity to INF. and you happen to fail the NS5B  drug (sovaldi) for the same reason then your options may be very limited beyond that  as resistance issues are still greatly unknown.

Best...
Will

[48weeks]

Thanks Magtx, I wonder if my Hepatologist knows what he's doing. He's Mr. Big at Einstein in Philly. Everything everyone is saying makes sense, wonder what he's thinking.