Aa
prior nonresponder question
i heard that the response of prior non responders that have cirrhosis is only 14%.....that is scary? does anyone know anything about this?
i will check into that, but i have another problem that may prevent me from entering trials.............ty for the info and please keep me in ur prayers
Sorry to hear about your previous response Your attitude about "not one to lay down and take it " is a great one..
Was that the only viral load test done (at 5months into treatment?) If you had no viral load decrease at all then as stated above you were a "null responder" in other words insensitive to the drug "interferon.
Unfortunately as Susie and Hector have posted above ..without an adequate INF. response the addition of the current DAA"s ( Vic & Inci) really only raise the odds slightly as you can see).
My advice would be to see if you can enter a trial perhaps one without the use of Interferon .or one that uses multiple DAA's (with INF.)
I don't stay that current on all the trials now recruiting ,however if you go to this link and put in your area possibly there is something for you there.
http://clinicaltrials.gov/ct2/search
Best of luck...
Will
Was that the only viral load test done (at 5months into treatment?) If you had no viral load decrease at all then as stated above you were a "null responder" in other words insensitive to the drug "interferon.
Unfortunately as Susie and Hector have posted above ..without an adequate INF. response the addition of the current DAA"s ( Vic & Inci) really only raise the odds slightly as you can see).
My advice would be to see if you can enter a trial perhaps one without the use of Interferon .or one that uses multiple DAA's (with INF.)
I don't stay that current on all the trials now recruiting ,however if you go to this link and put in your area possibly there is something for you there.
http://clinicaltrials.gov/ct2/search
Best of luck...
Will
i took the interferon/riba treatment in 2005.....started with a viral load of 3 mil and 5 months later it hadnt dropped at all. i now have stage 4 fibrosis and 1 stage cirrhosis. im gonna do the treatments because im not one to just lay down and take it. but i am curious to know what others have heard or been through. ty for responding
If one has never had a 2 log drop (null-responder). and is cirrhotic, unfortunately it is true, the success rate is 14% for an SVR with the new drugs. That is why I am not trying. I think we need to wait for a 2 DAA treatment with Peg/riba. A trial might be better for those of us null responders who want to treat now.
HCV Treatment History: There is a growing population of people who did not have a sustained virological response from HCV treatment. They are sometimes referred to as "treatment failures," but the term "treatment-experienced" is preferable, although both are not sufficiently specific.
It is important to know how treatment-experienced people responded to their first course of treatment, and the regimen that they were treated with, because these factors help to predict the likelihood of SVR from re-treatment. People initially treated with standard interferon, or standard interferon plus ribavirin, may achieve SVR when re-treated with pegylated interferon and ribavirin. Sometimes, HCV re-treatment trials study a mixed population of relapsers, partial responders, non-responders, and null responders, which makes it difficult to interpret the results.
Null Responder: A null responder is someone who achieves little or no decrease in hepatitis C viral load during HCV treatment. Null responders are highly unlikely to respond to re-treatment with an interferon-based regimen.
Non-responder: Often referred to as a "treatment failure," a non-responder is someone who does not have an EVR or, if they stay on treatment for 24 weeks, does not ever have a 2-log (99%) drop in hepatitis C viral load or undetectable HCV RNA during hepatitis C treatment.
Partial Responder: A partial responder is someone who experiences at least a 2-log decrease in hepatitis C viral load during HCV treatment. Partial responders are more likely to respond to re-treatment than non-responders or null responders.
Relapser: The term relapser refers to someone who has had an EVR or ETR, but whose virus rebounded after they completed HCV treatment. People who had a relapse after completing HCV treatment are more likely to achieve SVR after re-treatment than partial responders, non-responders, or null responders.
It is important to know how treatment-experienced people responded to their first course of treatment, and the regimen that they were treated with, because these factors help to predict the likelihood of SVR from re-treatment. People initially treated with standard interferon, or standard interferon plus ribavirin, may achieve SVR when re-treated with pegylated interferon and ribavirin. Sometimes, HCV re-treatment trials study a mixed population of relapsers, partial responders, non-responders, and null responders, which makes it difficult to interpret the results.
Null Responder: A null responder is someone who achieves little or no decrease in hepatitis C viral load during HCV treatment. Null responders are highly unlikely to respond to re-treatment with an interferon-based regimen.
Non-responder: Often referred to as a "treatment failure," a non-responder is someone who does not have an EVR or, if they stay on treatment for 24 weeks, does not ever have a 2-log (99%) drop in hepatitis C viral load or undetectable HCV RNA during hepatitis C treatment.
Partial Responder: A partial responder is someone who experiences at least a 2-log decrease in hepatitis C viral load during HCV treatment. Partial responders are more likely to respond to re-treatment than non-responders or null responders.
Relapser: The term relapser refers to someone who has had an EVR or ETR, but whose virus rebounded after they completed HCV treatment. People who had a relapse after completing HCV treatment are more likely to achieve SVR after re-treatment than partial responders, non-responders, or null responders.
Hi..
Are you starting treatment again?. Did you treat previously and what do you mean by "non-responder"?
The term can include "nulls, Partials " and "relapsers" and the trial results with Incivek and Victrelis had different success rates depending on the previous type of response as well as many other factors as"tekelcat" has mentioned.
Many patients with cirrhosis have SVR'd with the addition of the New drugs .
Good luck...
Will
Are you starting treatment again?. Did you treat previously and what do you mean by "non-responder"?
The term can include "nulls, Partials " and "relapsers" and the trial results with Incivek and Victrelis had different success rates depending on the previous type of response as well as many other factors as"tekelcat" has mentioned.
Many patients with cirrhosis have SVR'd with the addition of the New drugs .
Good luck...
Will
Null Responder = A person who has less than a 2 log10 drop in viral load at the 12th week of SOC treatment.
"Data from the REALIZE trial showed much lower SVR rates with telaprevir-based therapy among previous null responders to peginterferon/ribavirin with cirrhosis (14%) or bridging fibrosis (30%). Similar data are not available for boceprevir because of the exclusion of null responders in the RESPOND-2 trial."
"...Similarly, when planning to use boceprevir in patients with compensated cirrhosis, my colleagues and I implement the 4-week peginterferon/ribavirin lead-in phase, as indicated in the boceprevir prescribing information. We wait to see the HCV RNA results at Week 4 before deciding whether to expose patients to boceprevir. If patients do not have at least a 1-log10 reduction in HCV RNA from baseline, we defer therapy or enroll patients in clinical trials. Other experts follow the recommendations in the prescribing information and continue therapy until the 12-week futility rule evaluation point and use response at this time point to determine whether treatment should be continued."
From - "Current Recommendations for Using Telaprevir and Boceprevir in Patients With Advanced Fibrosis or Cirrhosis"
Paul J. Pockros, MD
Posting Date: December 19, 2011
Head, Division of Gastroenterology/Hepatology
Director, SC Liver Research Consortium
Clinical Director of Research, Scripps Translational Science Institute
The Scripps Clinic
La Jolla, California
hector
"Data from the REALIZE trial showed much lower SVR rates with telaprevir-based therapy among previous null responders to peginterferon/ribavirin with cirrhosis (14%) or bridging fibrosis (30%). Similar data are not available for boceprevir because of the exclusion of null responders in the RESPOND-2 trial."
"...Similarly, when planning to use boceprevir in patients with compensated cirrhosis, my colleagues and I implement the 4-week peginterferon/ribavirin lead-in phase, as indicated in the boceprevir prescribing information. We wait to see the HCV RNA results at Week 4 before deciding whether to expose patients to boceprevir. If patients do not have at least a 1-log10 reduction in HCV RNA from baseline, we defer therapy or enroll patients in clinical trials. Other experts follow the recommendations in the prescribing information and continue therapy until the 12-week futility rule evaluation point and use response at this time point to determine whether treatment should be continued."
From - "Current Recommendations for Using Telaprevir and Boceprevir in Patients With Advanced Fibrosis or Cirrhosis"
Paul J. Pockros, MD
Posting Date: December 19, 2011
Head, Division of Gastroenterology/Hepatology
Director, SC Liver Research Consortium
Clinical Director of Research, Scripps Translational Science Institute
The Scripps Clinic
La Jolla, California
hector
I dread an unambiguous affirmative on that stat as I am a previous non responder (or partial at best) with cirrhosis who achieved a dramatic viral response within a week of therapy and a confirmed undetectable within 10 days of triple (Incivek) tx. I am about 7 months into it now (post Incivek- ribo and interferon exclusively) and remain undetectable. I'm hoping my RVR postures me for greater success than 14%!!
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