Acronym question about a 2lg. drop??

[fretboard]

My question is, if you are UND by week 4 is that considered an RVR or a super response and is there such a thing as a super response?  What acronym is used for that?   I was also wondering if anyone on this forum rec'd an RVR by week 1 or 2?  Please share, I'm on here to educate myself and there are so many variables involved with the HepC tx.    I know that some of the clinical trials you must have a 2 lg drop by week 4 to continue onward or you get dismissed.  Is that a 2lg drop weekly for 4 weeks steadily?  Or is it just a 2lg drop by week 4?  Thanks in advance for any responses.  later  

[CockSparrow]

> I was also wondering if anyone on this forum rec'd an RVR by week 1 or 2?
Yes you can be UND by week 2. Week 1 is probably pushing it.

Excellent Post Hector.
The only thing i'd like to add is that G1 LVL RVRs also have 90% SVR odds with 24 weeks. Drops a bit with HVL.

CS

[HectorSF]

Hope this helps...

RVR = Undetectable HCV RNA by treatment Week 4.

Rapid virologic response occurs in approximately 15% of patients with HCV genotype 1 and 66% of patients with HCV genotypes 2 or 3 treated with peginterferon alfa and ribavirin. It is critically important to identify patients with RVR because these patients have up to a 90% SVR rate if they remain on treatment for 48 weeks for HCV genotype 1 infections (and 24 weeks for HCV genotype 2 and 3 infections).

EVR = greater than or equal to 2 log decline in HCV RNA from pretreatment baseline or UND HCV RNA in serum by treatment Week 12

Approximately 35% of genotype 1 patients achieve undetectable HCV RNA between Week 4 and 12 of treatment. Recently, these patients have been termed as having a “complete” EVR.

Another 15% of genotype 1 patients achieve undetectable HCV RNA between Week 12 and 24 of treatment and have been referred to as “slow to respond.”

Virtually no patients will achieve undetectable HCV RNA levels after Week 24 if they have not done so already by that time point, regardless of genotype. Therefore, if a patient has not achieved undetectable HCV RNA by Week 24, treatment should be stopped.

It is critically important to recognize the point at which a patient achieves undetectable HCV RNA during treatment as this is directly related to the likelihood of achieving a SVR. In other words, the later a patient achieves undetectable HCV RNA during treatment, the higher the likelihood that the patient will relapse after treatment is discontinued following the standard duration of therapy (24 weeks for genotypes 2/3 and 48 weeks for genotype 1). Three recent studies have now demonstrated that relapse can be significantly reduced in slow-to-respond genotype 1 patients—those who achieve undetectable HCV RNA after Week 12—by extending the duration of treatment from 48 to 72 weeks. In each of these studies, the relapse rate was reduced from more than 50% to less than 20%.

"super response" no such term. RVR gives you a 90% chance of SVR. I'd say that's SUPER.
2lg drop by week 4. As VL is measured at week 4 of treatment.

In summary:
Patterns of virologic response is used as a predictor of achieving SVR.

Hector