Re-treating with DAA's?

[BigDaddy_59]

Anybody know the time frame for being able to re-treat with DAA's (once you have been on them)? I have heard estimates of years but have never seen anything definitive. I know there is concern about resistance and wild variants.

Excited about the news results from Abbott about the interferon free treatment and the high SVR rates especially for previous non-responders!

Thanks, Chris

[flyinferg]

i am half way thru a three month trial using the above mentioned Daclatasvir and TMC435. one pill a day, with food, for each. i started at 13million and i am undected as of the third week. 41 years with hep c, no symptoms. i just happened upon this trial while meeting with the fabulous dr. peters for my yearly check-up (always the same numbers) at ucsf.
some days are fine, some days are exhausting.  i feel so fortunate that this is a short trial. my heart and hope goes to all of the folks on the longer treatment regimens.  madeleine    (the study is through Bristol-Myers Squibb and Janssen R&D )

[rivll]

I was told that in my study with 7977 and Riba, 25% of the ppl relapsed after treatment for 12 weeks.
I think the addition of Daclavitsvir (sp?) or another oral in the pipeline increases the odds for genotype 1.

[HectorSF]

There are no known variants when treating with Gilead's GS-7977 + Ribavirin. It has a high barrier to the development of viral resistance. It is a non-interferon all oral treatment now being studied in clinical trials. Therefore everyone in published trials becomes undetectable by week 4 at the latest and 98% to 99% of patients in each study group had achieved HCV RNA levels below the limits of detection. Patients only fail treatment by relapsing after they stop treatment.

Cheers!
Hector

[his3707]

my study doc just told me they were quickly coming out with drugs to combat the varients.

[HectorSF]

Chris,

As you said the estimate is "years". And the treatment has only been available on the market for 1 1/2 years so...

The censuses seems to be, by the time people would retreat non-interferon based treatment will be available so people should wait. Of course this leaves people with cirrhosis that may have decompensation of their cirrhosis during that time period high and dry. What else is new?
-----------------------------------------------------------------------------------------
From "Clinical Care Options"

"Reversibility and Persistence of Resistance Associated Variants Following Treatment With Approved HCV Protease Inhibitors
Source: Clinical Implications of HCV Resistance: Laying the Foundation for Optimal Treatment Today and in the Future"

Release Date:
June 13, 2012

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20Resistance/Expert%20Viewpoints/Expert_Viewpoint_3.aspx

"Conclusions

"Resistant variants detectable after stopping telaprevir- or boceprevir-based therapy in patients who experience treatment failure are generally no longer detectable by population sequencing in the majority of patients 2-3 years after discontinuation of treatment. Reversion to wild-type virus over time in the absence of selection pressure occurs, as drug-resistant variants have no replicative advantage over wild-type virus. The clinical relevance of RAVs identified many years after short-term exposure to boceprevir or telaprevir is unclear. Drug resistance in HCV infection, therefore, may revert. However, whether pretherapeutic drug susceptibility is restored and whether the observed data imply a high likelihood of success with future treatment will require proof from trials designed to test these hypotheses."

So it is still unknown if retreatment would provide any benefit.


Cheers!
Hector