Aa
vx950
im having a freaking panic attack i ******* hate having this dam disease ...sometimes i cant belieeve what an idiot i am for my stupid stupid past..
ok now that thats over haha here is my question:
i have fingers crossed i am getting on this trial in a few weeks for tx naive, i am not really tx naive however since i did a trial 4 years ago with peg and viramidine, i was dropped at 6 months and was just told it was not working i never got any info on VL nothing... just want some opinions im wondering if my odds of SVR are the same (80% or better) as tx naive??
i have the kind of luck to be in the other 20% ... im just so scared sometimes most of the time i am fine, i really have no problems with the hep but i just cant stand knowing what it is doing to me anymor... i have seen someone die of liver failure and its hard to thnk of a worse way to go other than the big C..
ok now that thats over haha here is my question:
i have fingers crossed i am getting on this trial in a few weeks for tx naive, i am not really tx naive however since i did a trial 4 years ago with peg and viramidine, i was dropped at 6 months and was just told it was not working i never got any info on VL nothing... just want some opinions im wondering if my odds of SVR are the same (80% or better) as tx naive??
i have the kind of luck to be in the other 20% ... im just so scared sometimes most of the time i am fine, i really have no problems with the hep but i just cant stand knowing what it is doing to me anymor... i have seen someone die of liver failure and its hard to thnk of a worse way to go other than the big C..
za: thanks for that info, I now see that I was a complete null-responder on my last round of tx and this time, by adding the PI I have responded.
pj: hope, there is hope!!!
pj: hope, there is hope!!!
It does matter if you are a slow responder or a non-responder to SOC. At least if you treat again with just SOC. There are trials now to determine how effective the PIs are treating non-responders. It is looking hopeful.
Slow responders have a fairly good chance of SVR with 72 weeks of SOC, and adding the PIs I am certain their odds will increase. They have responded to interferon, which is the important thing, just slowly.
Non-responders to SOC can be divided into:
null response (no response at all to interferon)
breakthrough (after becoming UND during tx, the virus breaks through while still treating)
partial responders (have a 2 log drop by week 12, but are not UND by week 24.
So as you see partial responders do respond to interferon, just not enough. Patients with breakthrough have responded, but the virus broke through. Null responders have had no response at all.
It will be interesting to see how much the odds of SVR will be improved for these 3 different groups of non-responders by adding the PIs.
Hope my answers to your questions are helpful,
Za
Slow responders have a fairly good chance of SVR with 72 weeks of SOC, and adding the PIs I am certain their odds will increase. They have responded to interferon, which is the important thing, just slowly.
Non-responders to SOC can be divided into:
null response (no response at all to interferon)
breakthrough (after becoming UND during tx, the virus breaks through while still treating)
partial responders (have a 2 log drop by week 12, but are not UND by week 24.
So as you see partial responders do respond to interferon, just not enough. Patients with breakthrough have responded, but the virus broke through. Null responders have had no response at all.
It will be interesting to see how much the odds of SVR will be improved for these 3 different groups of non-responders by adding the PIs.
Hope my answers to your questions are helpful,
Za
This is how I understand it to be:
SOC (standard of care) consists of pegylated interferon and ribavirin. These two drugs do not directly attack the virus, instead they boost our immune system so the immune system can kill the virus. Remember interferon is naturally produced in the body, just not in the amounts we need to get rid of the hepatitis C virus.
So because interferon and ribavirin do not attack the virus, the virus does not become resistant to them. This means that next treatment round the virus does not recognize the drugs, and it is like one has never treated before. If you used the same drugs and the same dose and the same treatment duration, you would be likely to have the same outcome.
The new protease inhibitors and polymerase inhibitors go directly in and inhibit (as one can hear from the name) the replication of the virus. If treatment is not successful, next treatment round there will be a memory in some mutated virus copies which remember the PIs, and these drugs will not be effective anymore.
SOC (standard of care) consists of pegylated interferon and ribavirin. These two drugs do not directly attack the virus, instead they boost our immune system so the immune system can kill the virus. Remember interferon is naturally produced in the body, just not in the amounts we need to get rid of the hepatitis C virus.
So because interferon and ribavirin do not attack the virus, the virus does not become resistant to them. This means that next treatment round the virus does not recognize the drugs, and it is like one has never treated before. If you used the same drugs and the same dose and the same treatment duration, you would be likely to have the same outcome.
The new protease inhibitors and polymerase inhibitors go directly in and inhibit (as one can hear from the name) the replication of the virus. If treatment is not successful, next treatment round there will be a memory in some mutated virus copies which remember the PIs, and these drugs will not be effective anymore.
This paper is excellent for learning the basics:
MEDICAL CROSSFIRE, special edition: Chronic Hepatitis C, Strategies for Optimizing Current Treatment and the Potential Impact of Emerging Therapies
http://www.medicalcrossfire.com/onlineLearning/cme/2006/06-LC-27-M-100.pdf
MEDICAL CROSSFIRE, special edition: Chronic Hepatitis C, Strategies for Optimizing Current Treatment and the Potential Impact of Emerging Therapies
http://www.medicalcrossfire.com/onlineLearning/cme/2006/06-LC-27-M-100.pdf
i have another ? i will ask here so as not to clog up the board wit all my stupid questions haaaaaaaa
what does 'non-responder' mean exactly? does it mean your viral load does not drop at all ?
unfortunatley i dont know if im a nonresponder or a slow responder when they dropped me from the virimadine trial but i guess it doesnt matter right? i mean are the odds of SVR with SOC on a second go around the same for non-responders as they are for slow responders? less than 10% or something?
what does 'non-responder' mean exactly? does it mean your viral load does not drop at all ?
unfortunatley i dont know if im a nonresponder or a slow responder when they dropped me from the virimadine trial but i guess it doesnt matter right? i mean are the odds of SVR with SOC on a second go around the same for non-responders as they are for slow responders? less than 10% or something?
Good Luck, I hope things work out for you. Love to have you join us in treatment soon. Misery loves company!!
Trin
Trin
im sorry i dont understand, what do you mean by 'no resistance issue'?
i know the SVR results for the phase iii virimadine trial were less then they had hoped, well below SOC which isnt very high to begin with... i believe thats why it was never given FDA approval, the virimadine is just not that effective...
i really hope i get on this trial, i read the results for the phase ii trials for vx950 and they were really good and that was with only 12 weeks of TX ... phase iii is 24 to 48 weeks, i think if you are UND by 4 wks they will continue to 24 wks and then stop but if it takes longer to get to UND they will tx the full 48 wks
im cautiously hoping #1 that i get on the trial at all and #2 THAT IT WORKS ... just dont know if i can take another 'sorry it didnt work' result ...
it has to work right ??!!! for all of us...
i know the SVR results for the phase iii virimadine trial were less then they had hoped, well below SOC which isnt very high to begin with... i believe thats why it was never given FDA approval, the virimadine is just not that effective...
i really hope i get on this trial, i read the results for the phase ii trials for vx950 and they were really good and that was with only 12 weeks of TX ... phase iii is 24 to 48 weeks, i think if you are UND by 4 wks they will continue to 24 wks and then stop but if it takes longer to get to UND they will tx the full 48 wks
im cautiously hoping #1 that i get on the trial at all and #2 THAT IT WORKS ... just dont know if i can take another 'sorry it didnt work' result ...
it has to work right ??!!! for all of us...
My understanding is that there is no resistance issue with interferon and ribavirin. I would think this would also hold true for viramidine since it is a prodrug of ribavirin.
You obviously did not respond that well to interferon and viramidine, but I don't know how the SVR rate on these drugs compare to the SVR rate for SOC. So it is difficult to say anything about what your odds are this time. Adding a PI to SOC looks very promising however, so I would say you probably have a pretty good chance of SVR.
Good luck!
You obviously did not respond that well to interferon and viramidine, but I don't know how the SVR rate on these drugs compare to the SVR rate for SOC. So it is difficult to say anything about what your odds are this time. Adding a PI to SOC looks very promising however, so I would say you probably have a pretty good chance of SVR.
Good luck!
PJ
I don't really know the exact odds - I don't think anyone can. But due to the fact that you were on peg before it is supposed to make it harder as you may have some immunity. That said - telepravir seems to be a miracle drug for those that it works for knocking down that viral load so fast.......
Just take each day as it comes. Even if you line up all the cards exactly in a row you can never know if you will be one of the lucky ones or not. All you can do it have faith and do the best that you can and hope that it works for you.
If you do nothing however you know it has ZERO chance of working.........so whatever the odds are, they are certainly better than THAT!
Good luck,
I don't really know the exact odds - I don't think anyone can. But due to the fact that you were on peg before it is supposed to make it harder as you may have some immunity. That said - telepravir seems to be a miracle drug for those that it works for knocking down that viral load so fast.......
Just take each day as it comes. Even if you line up all the cards exactly in a row you can never know if you will be one of the lucky ones or not. All you can do it have faith and do the best that you can and hope that it works for you.
If you do nothing however you know it has ZERO chance of working.........so whatever the odds are, they are certainly better than THAT!
Good luck,
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