Triple combination treatment

[Forum419]

Pt on Incivek/Peg/Riba tx had to D/C Incivek at the end of first week of tx, secondary to progressively worsening generalizing rash and systemic symptoms. She continues Peg/Riba and she is improving at wk 2 . It is feasible to switch to Victrelis and when to introduce it? HCV RNA  is pending, the rest of the labs nl.

[Advocate1955]

My husband's hepatologist said that if triple therapy with Incivek does not work for him, they cannot treat him with Boceprevir because they are too similar and wouldn't work.  She said the next step would be to wait for the next round of new drugs.  He is a partial responder, not a non responder, to previous treatments.
Advocate 1955

[can-do-man]

Yes do talk with a doctor that has worked with both of these drugs, this is what i found.

Currently, there is no evidence to support switching from one PI to the other if treatment is not successful. The safety and efficacy of switching to the other PI because of a drug-specific adverse event also has not been established. Likewise, a patient for whom one PI was not successful should not be retreated with a regimen containing the other PI.

But that doesn't mean its not possible to treat with boceprevir in the future as it also states,

Fear of resistance should not be a reason to withhold telaprevir or boceprevir from a patient who is expected to benefit from therapy because resistance can be minimized as long as stopping rules are adhered to and it does not necessarily disqualify patients from future therapeutic options.

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20New%20Agents/Module/Practical_Guide/Pages/Page%205.aspx.

Also we do have one here that treated with incivek and is now treating with victrelis...... rockymoe....... might send a pm to her.

HONDA.............. Your doctor either mispoke or is wrong about that, many naive people is and have been treating with Inc.

[hondapatches]

I thought Incivek was for non responders. PPl who have tried became neg and after treatment it came back. At least that is what my dr. told me. I was on the Peg/Ribo my bloodwork came back neg for 10 months then when I got off of the treatment it came back. :(   I don't see why they couldn't just add the Victrelis to her treatment. You would have to ask the Dr. if it is feasible.

[hrsepwrguy]

This is a very good question but one that should be discussed with a doc that has expirience using the new PI's.
From what I have read once the PI has been stopped it should not be reintroduced as far as cross resistance issue's between the 2 PI's I believe there might be a probem, like I said it is something that should be discussed with a doc with exp using the new PI's
PI= protease inhibitor=Incivek and victrelis