if you stop incivek at 10 weeks or so

[working dog]

and you were und at 4 weeks....do you do 48 weeks tx??...thanks...billy

[willbb]

No one to date has SVR"d on Inci  in 24 or 48 weeks....other than in trials...

[lynda607]

I assumed because you stated "from my experience and knowledge in order to have real fighting odds of SVR-ing with 24 weeks of tx you need to have gone UND by week 3 latest meant that the patient must be UND by wk 3 as opposed to wk 4 or the chance of SVR is dimished. The statement after that referenced "Nearly all that I know that went on to SVR with 24 weeks of tx were UND by week 3"

If your first statement was anecdotal, I missed it.

[mremeet]

You need to re-read what I said above. I didn't say working dog didn't have "fighting odds" if he was not UND by week 3. I said most all I knew (anecdotally) who went on to SVR with 24 weeks of tx were UND by week 3 (and most earlier than that). I suggested he not opt for shortened (24 week) treatment if he was still detectable at week 4. This is in concurrence with Vertex recommended treatment guidelines as you have referenced.

[working dog]

i sure am taking a hit on this triple tx...but i'm going on week 11 and maybe i'll make through the next 2 weeks...but for sure if the 180 interferon with the 1200 riba...is going to hurt my body long term and i could have avoided it i would feel lazy if i didn't take the time to research this as best that i could...to end up with long term sides when i could have cut my dose down and been in the same boat wouldn't feel right...thanks for the info aj...just think in a year from now with so many treating what we will know...in 1974 i cut my achilles tendon in half...hung on by a thread...they said 6 months in a cast..i took it off in 5 weeks..i was running 10 miles a day 6 months later...i'm not saying don't go by the book on this...it's just that the book is changing so fast we have to keep up with it..thanks...billy

[Ajw78757]

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/Battling%20HCV/Interactive%20Virtual%20Presentations/Adverse%20Events.aspx

On the video that was posted above During the advance trials of teleprevir, they did a 8 week and a 12 week teleprevir treatment period.

People who eRVR (UND @ 4 weeks) and stopped Teleprevir @ 8 weeks
the SVR rate was only 6% less than people who continued for 12 weeks.

Additionally, in the advance and illuminate trials, dose reduction of riba and interferon after one is already undetectable had little to no effect on SVR.

What I am going to do is ask my Dr opinion on this.

I have a hard time gambling, even just 6% to stop 4 weeks early,
but- if reducing the riba and interferon is possible after week 12, I say we do it.

I would never decide this on my own, I will discuss it with my family and doctor before I make any decision.

[lynda607]

Vertex protocol recommends a viral load done at wk 4 and 12 only.  This is in their submission to the FDA and in the published prescribing guidelines. Many doctors and insurance companies will follow that protocol so they will not know at what week the patient actually went UND prior to the 4 week PCR.  Incivek is fast acting in most case the patient will be UND by wk 2 or 3 but if eRVR (UND at 4 & 12) the patient qualifies for the 24 wk shortened treatment duration and the odds of SVR are above 85%.  So to say in order to have real fighting odds of SVR with 24 wks of tx you need to have gone UND by week 3 latest does not correspond with the trial data and RGT guidelines Vertex has released.

[mremeet]

If what the others say is true and you were not UND at week 4 with triple therapy, then I definitely would not stop at 24 weeks. From my experience and knowledge in order to have real fighting odds of SVR-ing with 24 weeks of tx you need to have gone UND by week 3 latest. Nearly all that I know that went on to SVR with 24 weeks of tx were UND by week 3. I dont know the details of what's happening in your treatment, but don't delude yourself into thinking you have any real odds of winning with only 24 weeks of tx. If still detectable at week 4 on triple therapy, odds are probably not in your favor with the shorter tx.

[his3707]

Here is the link about managment  of triple therapy that was posted by willib I think....  if you have never been on this site before you might have to register.  Very well worth it since its free and has fantastic up to date info about what is going on in the real world.   God Bless


http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/Battling%20HCV/Interactive%20Virtual%20Presentations/Adverse%20Events.aspx

[frijole]

I guess I can through my 2 cents in here.  You were not undetectable at week 4.  Unless you can get a sensitive test done right now, you probably are not going to have another PCR until week 12 and that hopefully will be UND.  How many days is it until the 12 weeks are over?  No one can tell you what to do.  If you can't handle it you can't and that is that.  However do not expect anyone to predict your chances of SVR

frijole

[his3707]

  You have had a horrible time so far on this treatment.  You have two more weeks to go.  I know as well as you there are people that stop treatment early for many reasons who go on to be cured.  But those reasons are not your reasons yet.   If you didnt quit while you were laying on that table, your not gonna quit now!  I thought I was gonna die with Rash, anemia, puking my guts up nearly every day etc.    You have come this far, another 14 days is nothing and you sure has hell dont want to do this again!!   Hang in there!!  you can do this!!   Maybe we should sedate you for a couple of weeks :)  
It looks like your questions though, was if you stop incivek at 10 weeks and yu were undetected at week 4 do you do 24 or 48 weeks?   Well, I think the answer to that would be, you would do 24 if you were undected at 4 and 12.  If not you do 48 no matter when if you stop the telaprevir at 10 or 12.    Did that help?  

[desrt]

What was your IL28B result?

[desrt]

Agree with mremeet and can-do-man: there are those of us who have done less than the prescibed amount or duration (either through necessity or choice) and gone on to SVR  -  but if you do it by choice, man up and own the decision. Don't ask anyone else to co-sign it.

[lynda607]

I agree - not logical to consider stopping the Incivek at 10 wks, no eRVR and then doing only 24 wks total?  Random thoughts, wishful thinking, call it what you want but you can't justify it.

[shanro]

hey we can start our own 48 weeker club!!  we CAN do this!

[can-do-man]

Billy, you were NOT und at week 4, people have pointed out studies with the % on why one should do 48, your own doctor has said you need to do 48 weeks. Yet you keep starting thread after thread, i guess you want people to just agree with your way of doing tx.

The question is "Do you feel lucky"

[crossroadsec]

Settle down now billy. Don't do anything rash. No pun intended. You're right there within a few days ahead of me. This may sound girlie, but you need to pinkie swear you will do everything you can for as long as you can until your dr. says otherwise. Isn't that what we said from day 1?
I know you'll make your own decision. I know our stories have many similarities, but also vary. You know what you can live with. Have you thought lately about some goals you have? A special trip? New hobby? A concert? There's a big planet waiting to be explored.... xoxo my friend. Karen :)

[mremeet]

Working dog I stopped Incivek (then known as Telaprevir) at week 6 and went on to SVR fine after 40 weeks of troubled treatment. i.e. Reduced ribavirin dose and taking powerful immunosuppressants to control the aftermath of an Incivek rash.

Incivek does most of what it's going to do within the first 4-6 weeks. Most people that took triple therapy and would go on to SVR later at 24 weeks or 48 were undetectable by week 2 or 3 (using a PCR with a sensitivity of <10 IU/ml ). I don't know how bad you're treatment is going, but many went on to SVR with much less than 48 weeks of treatment.

On the other hand? It's all a gamble. The longer you stay under the effects of IFN and riba after getting off Incivek the better your chances of SVR-ing. Think of it as insurance. Buying insurance doesn't mean you'll need it and it could be a waste of money. But in the event you do need it? You'll be *really* glad you got it when you could.

[shanro]

billy - i completely empathize with you but please don't make any decisions right now... keep it in the moment... it sounds like you're hitting a road block but if you can get through this to the other side it'll get different... i feel like you'll regret it if you quit before the miracle happens but you won't regret it if you just hang on... keep communicating with people in here and your family/friends/doctor/nurses... call one of the hotlines... do whatever it takes to get through this... your liver and your life are both worth it...
-shanna

[Aaron57]

Been reading your recent posts WD ... Sorry to hear you are having a rough week 10 ..

Would suggest you ask your medical practitioner if you are considering an alternative course of action....

Someone correct me if I am mistaken .. I don't believe there are any studies that used a 10 wk. cutoff point for Incevik ....

Lots of folks did not make it through the clinical trials for these drugs ... due to many reasons ...

Hector kindly supplied you with a very comprehensive account of known Tx responses, protocols and very importantly ... concerns of mutant's .... and some of the studies the data was taken from.

"The week 4 VL test shows how effective the DAA is in stopping the replication of the wild virus. The main hepatitis C virus itself. Often we will see a many log drop. It also shows how effective the peg-IFN and ribavirin are in ridding the body of the hepatitis C mutant viruses.

Week 12 is a confirmation the the Peg-IFN and ribavirin have stopped the replication of the mutants viruses which become the majority of the virus in the body after the wild virus is suppressed."

You also stated:
"and we all know new tx will be coming soon that are better"

This is yet to be proven and may take several years before it is, and the next generation drugs approved by FDA ..

To me it depends on liver condition ... can a person wait or not ? But thats just me ....

Hope you can hang in there & tx gets easier . Cheers

[hrsepwrguy]

My thoughts exactly deb just to tired to type

You were not eRVR at 4 weeks so the question is pointless.

[hrsepwrguy]

nygirl7  
23 minutes ago ..Billy I think everybody on this forum reallizes that you are totally into making your own treatment protocol and most likely have no intention of doing 48 weeks anyways so it's kind of like beating a dead horse just asking isn't it? .