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1747881 tn?1546179478

concentration controlled ribavirin dosing

I am in a trial that will be comparing ribavirin dosing, weight based compared to concentration controlled based on AUC 0-12 after first dose.


Primary Outcome Measures:
•ribavirin AUC-12 variability [ Time Frame: steady state (~weeks 9-10) ] [ Designated as safety issue: No ]
Demonstrate that concentration-controlled ribavirin dosing can achieve a targeted level of plasma exposure with reduced variability in the steady-state area-under-the-concentration-time curve (AUC0-12) compared with standard weight-based ribavirin dosing

Secondary Outcome Measures:
•safety - absolute hemoglobin declines [ Time Frame: end of treatment ] [ Designated as safety issue: Yes ]

•efficacy - early and sustained virologic response [ Time Frame: EVR (12 weeks) and SVR (24 wks after cessation of treatment) ] [ Designated as safety issue: No ]
Compare proportions with EVR and SVR in standard weight-based vs. concentration-guided ribavirin dosing groups

I start tommorow morning, arms will be decided in week 2, I will keep everyone interested posted on my numbers as much as possible.

10 Responses
Avatar universal
In the ribavirin concentration controlled arm those with an AUC0-12h > 7000 or < 3000 ng*hr/mL will have their doses adjusted to a target AUC0-12h of approximately 5000 ng*hr/mL.  i agree that the concentration controlled arm is the place to be. but should you end up in the SOC arm and get either 1000mg or 1,200mg ribavirin per day your chances of SVR will be equivalent to anyone following the label.  you will also have the opportunity to use rescue drugs, if you can figure out how to pay for them.
179856 tn?1333550962
Why are they doing this this was already proven a few years ago that weight based is imperative?
1747881 tn?1546179478
Not sure but this one includes incivek
179856 tn?1333550962
I wouldn't let anyone under dose me I dont care what, since the drugs do not work stand alone it seems awful risky.  If anything make sure you are getting extra.....
1747881 tn?1546179478
Actually I'm hoping for the controll arm but it is not just dose decrease but increase as well depending on plasma exposer. I am not sure exactly what number they are looking for yet but will keep everyone posted as I go.
Avatar universal
here is another ribavirin concentration study published in 2008 and the forum's comments on the study. this study did not include telaprivir.
looks to me like if they get close to 5000ng you will have an excellent chance at SVR, assuming you are in the the concentration controlled arm.  i think this is far superior to weight based ribavirin. good luck and keep us informed.

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