Aa
16 week end of treatment
After being undected at Week 2 I have remained that way. Riba 1200 and Interferon 2a 180.
Is there support from the community that at week 16 and still being undected treatment could be stopped
with the same success at 24
R
Is there support from the community that at week 16 and still being undected treatment could be stopped
with the same success at 24
R
sure hope so cuz I just stopped at 13 weeks - got pulled - (see my journal for details)
Lot's of research say's pretty good odds - but watch the type of inter, quantities, baselines etc
I'm 2B My BL was over 2 mil - at 10 days was 203 - at 3.5 weeks was UND - still UND and plan on staying that way.
Here's a few I have - like thbis 85% one!
Shorter Treatment for Some Patients with Chronic Hepatitis C
A 12-week regimen of combination therapy was effective for some patients with genotype 2 or 3 infections.
Patients with hepatitis C virus (HCV) genotypes 2 and 3 are more responsive to treatment than are those with genotype 1. In this Italian trial that included 283 patients with HCV genotype 2 or 3, researchers determined whether the duration of treatment with peginterferon plus ribavirin could be shortened. Patients were randomized to a standard 24-week treatment group (70 patients) or to a "variable-duration" group (213 patients). In the latter group, patients with negative test results for HCV RNA at 4 weeks received only 12 weeks of treatment, and those with positive test results received full 24-week treatment courses.
In the standard group, 76% of patients had sustained virologic responses (no detectable HCV RNA at 24 weeks after therapy had been completed). In the variable-duration group, about two thirds of patients were negative for HCV RNA at 4 weeks and thus received only 12 weeks of treatment; their response rate was 85%. Eighty patients in the variable-duration group were positive for HCV RNA at 4 weeks and received full 24-week courses of treatment; their response rate was 64%.
Comment: Among chronic hepatitis C patients with HCV genotype 2 or 3, 12-week courses of peginterferon plus ribavirin are sufficient for those who test negative for HCV RNA after 4 weeks of therapy. These findings are particularly important given the expense and toxicity of prolonged treatment for HCV infections.
— Allan S. Brett, MD
Published in Journal Watch General Medicine July 26, 2005
Citation(s):
Mangia A et al. Peginterferon alfa-2b and ribavirin for 12 vs. 24 weeks in HCV genotype 2 or 3. N Engl J Med 2005 Jun 23; 352:2609-17.
• Original article (Subscription may be required)
• Medline abstract (Free)
Randomized comparison of 12 or 24 weeks of peginterferon -2a and ribavirin in chronic hepatitis C virus genotype 2/3 infection
Accepted Article Online: 1 Feb 2008
Copyright © 2008 American Association for the Study of Liver Diseases
Abstract
Previous trials investigating the efficacy of treatment durations shorter than the standard of 24 weeks for chronic hepatitis C virus (HCV) genotype 2/3 infections have yielded discordant results. The aims of this investigator-initiated phase III study were to compare the efficacy of 12 or 24 weeks of treatment and to identify patients suitable for short-term therapy. Three hundred and eighty-two genotype 2/3 infected patients (ITT population) at 31 centers in Denmark, Finland, Norway, and Sweden were randomized to 12 or 24 weeks of peginterferon -2a 180 g/week plus ribavirin 800 mg/day. Twelve weeks of therapy was inferior to 24 weeks in the ITT population (SVR rates 59% vs. 78%, P<0.0001) and in the subgroups of patients infected with genotypes 2 (56% vs. 82%, p=0.006) or 3 (58% vs. 78%, p=0.0015). These differences were observed regardless of fibrosis stage. Age and HCV-RNA levels on days 7 and 29 were independent predictors of SVR. Short-term treatment was useful in patients <40 years especially if HCV-RNA was undetectable on day 29 and also in patients 40 years provided that HCV-RNA on day 7 was below 1,000 IU/mL in addition to being undetectable on day 29. If neither of these two criteria were met for patients 40 years, 24 weeks of therapy was superior (p<0.0001). In conclusion, peginterferon/ribavirin treatment for 12 weeks in HCV genotype 2/3 infection is overall inferior to 24 weeks, but may be useful in some patients with a rapid initial clearance of virus. (HEPATOLOGY 2008.)
--------------------------------------------------------------------------------
Received: 27 August 2007; Revised: 21 December 2007; Accepted: 23 January 2008
Pegylated interferon alfa and ribavirin for 14 versus 24 weeks in patients with hepatitis C virus genotype 2 or 3 and rapid virological response
Published Online: 1 Nov 2007
Copyright © 2007 American Association for the Study of Liver Diseases
Abstract - Nov 2007
A recent nonrandomized pilot trial showed that hepatitis C virus (HCV) patients with genotype 2/3 and rapid virological response (RVR) had a 90% sustained virological response (SVR) rate after 14 weeks of treatment. We aimed to assess this concept in a randomized controlled trial. In the trial, 428 treatment-naïve HCV RNA-positive patients with genotype 2 or 3 were enrolled. Patients with RVR were randomized to 14 (group A) or 24 (group B) weeks of treatment. Patients were treated with pegylated interferon -2b (1.5 g/kg) subcutaneously weekly and ribavirin (800-1400 mg) orally daily. The noninferiority margin was set to be 10% between the two groups with a one-sided 2.5% significance level. RVR was obtained in 302 of 428 (71%), and 298 of these were randomized to group A (n = 148) or group B (n = 150). In the intention-to-treat analysis, SVR rates were 120 of 148 (81.1%) in group A and 136 of 150 (90.7%) in group B (difference, 9.6%; 95% confidence interval, 1.7-17.7). Among patients with an HCV RNA test 24 weeks after the end of treatment, 120 of 139 (86.3%) patients in group A achieved SVR compared with 136 of 146 (93.2%) in group B (difference, 6.9%; 95% confidence interval, -0.1 to +13.9). Conclusion: We cannot formally claim that 14 weeks of treatment is noninferior to 24 weeks of treatment. However, the SVR rate after 14 weeks of treatment is high, and although longer treatment may give slightly better SVR, we believe economical savings and fewer side effects make it rational to treat patients with genotype 2 or 3 and RVR for only 14 weeks. (HEPATOLOGY 2007.)
--------------------------------------------------------------------------------
Received: 14 May 2007; Accepted: 10 August 2007
Digital Object Identifier (DOI)
Lot's of research say's pretty good odds - but watch the type of inter, quantities, baselines etc
I'm 2B My BL was over 2 mil - at 10 days was 203 - at 3.5 weeks was UND - still UND and plan on staying that way.
Here's a few I have - like thbis 85% one!
Shorter Treatment for Some Patients with Chronic Hepatitis C
A 12-week regimen of combination therapy was effective for some patients with genotype 2 or 3 infections.
Patients with hepatitis C virus (HCV) genotypes 2 and 3 are more responsive to treatment than are those with genotype 1. In this Italian trial that included 283 patients with HCV genotype 2 or 3, researchers determined whether the duration of treatment with peginterferon plus ribavirin could be shortened. Patients were randomized to a standard 24-week treatment group (70 patients) or to a "variable-duration" group (213 patients). In the latter group, patients with negative test results for HCV RNA at 4 weeks received only 12 weeks of treatment, and those with positive test results received full 24-week treatment courses.
In the standard group, 76% of patients had sustained virologic responses (no detectable HCV RNA at 24 weeks after therapy had been completed). In the variable-duration group, about two thirds of patients were negative for HCV RNA at 4 weeks and thus received only 12 weeks of treatment; their response rate was 85%. Eighty patients in the variable-duration group were positive for HCV RNA at 4 weeks and received full 24-week courses of treatment; their response rate was 64%.
Comment: Among chronic hepatitis C patients with HCV genotype 2 or 3, 12-week courses of peginterferon plus ribavirin are sufficient for those who test negative for HCV RNA after 4 weeks of therapy. These findings are particularly important given the expense and toxicity of prolonged treatment for HCV infections.
— Allan S. Brett, MD
Published in Journal Watch General Medicine July 26, 2005
Citation(s):
Mangia A et al. Peginterferon alfa-2b and ribavirin for 12 vs. 24 weeks in HCV genotype 2 or 3. N Engl J Med 2005 Jun 23; 352:2609-17.
• Original article (Subscription may be required)
• Medline abstract (Free)
Randomized comparison of 12 or 24 weeks of peginterferon -2a and ribavirin in chronic hepatitis C virus genotype 2/3 infection
Accepted Article Online: 1 Feb 2008
Copyright © 2008 American Association for the Study of Liver Diseases
Abstract
Previous trials investigating the efficacy of treatment durations shorter than the standard of 24 weeks for chronic hepatitis C virus (HCV) genotype 2/3 infections have yielded discordant results. The aims of this investigator-initiated phase III study were to compare the efficacy of 12 or 24 weeks of treatment and to identify patients suitable for short-term therapy. Three hundred and eighty-two genotype 2/3 infected patients (ITT population) at 31 centers in Denmark, Finland, Norway, and Sweden were randomized to 12 or 24 weeks of peginterferon -2a 180 g/week plus ribavirin 800 mg/day. Twelve weeks of therapy was inferior to 24 weeks in the ITT population (SVR rates 59% vs. 78%, P<0.0001) and in the subgroups of patients infected with genotypes 2 (56% vs. 82%, p=0.006) or 3 (58% vs. 78%, p=0.0015). These differences were observed regardless of fibrosis stage. Age and HCV-RNA levels on days 7 and 29 were independent predictors of SVR. Short-term treatment was useful in patients <40 years especially if HCV-RNA was undetectable on day 29 and also in patients 40 years provided that HCV-RNA on day 7 was below 1,000 IU/mL in addition to being undetectable on day 29. If neither of these two criteria were met for patients 40 years, 24 weeks of therapy was superior (p<0.0001). In conclusion, peginterferon/ribavirin treatment for 12 weeks in HCV genotype 2/3 infection is overall inferior to 24 weeks, but may be useful in some patients with a rapid initial clearance of virus. (HEPATOLOGY 2008.)
--------------------------------------------------------------------------------
Received: 27 August 2007; Revised: 21 December 2007; Accepted: 23 January 2008
Pegylated interferon alfa and ribavirin for 14 versus 24 weeks in patients with hepatitis C virus genotype 2 or 3 and rapid virological response
Published Online: 1 Nov 2007
Copyright © 2007 American Association for the Study of Liver Diseases
Abstract - Nov 2007
A recent nonrandomized pilot trial showed that hepatitis C virus (HCV) patients with genotype 2/3 and rapid virological response (RVR) had a 90% sustained virological response (SVR) rate after 14 weeks of treatment. We aimed to assess this concept in a randomized controlled trial. In the trial, 428 treatment-naïve HCV RNA-positive patients with genotype 2 or 3 were enrolled. Patients with RVR were randomized to 14 (group A) or 24 (group B) weeks of treatment. Patients were treated with pegylated interferon -2b (1.5 g/kg) subcutaneously weekly and ribavirin (800-1400 mg) orally daily. The noninferiority margin was set to be 10% between the two groups with a one-sided 2.5% significance level. RVR was obtained in 302 of 428 (71%), and 298 of these were randomized to group A (n = 148) or group B (n = 150). In the intention-to-treat analysis, SVR rates were 120 of 148 (81.1%) in group A and 136 of 150 (90.7%) in group B (difference, 9.6%; 95% confidence interval, 1.7-17.7). Among patients with an HCV RNA test 24 weeks after the end of treatment, 120 of 139 (86.3%) patients in group A achieved SVR compared with 136 of 146 (93.2%) in group B (difference, 6.9%; 95% confidence interval, -0.1 to +13.9). Conclusion: We cannot formally claim that 14 weeks of treatment is noninferior to 24 weeks of treatment. However, the SVR rate after 14 weeks of treatment is high, and although longer treatment may give slightly better SVR, we believe economical savings and fewer side effects make it rational to treat patients with genotype 2 or 3 and RVR for only 14 weeks. (HEPATOLOGY 2007.)
--------------------------------------------------------------------------------
Received: 14 May 2007; Accepted: 10 August 2007
Digital Object Identifier (DOI)
I would suggest readin this paper as it has data from 3-4 studies for genotype 2s and leading doctors eveluation of data.
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
"...the ACCELERATE trial, was coauthored by Dr. Shiffman.15 “It is
the largest of the four studies and included 1,469 patients with genotypes 2 and 3,” observed
Dr. Di Bisceglie. The patients were randomized to receive PEG-IFN alfa-2a plus
ribavirin for either 16 or 24 weeks. “This study was large enough to allow us to compare
responses in genotype 2 and genotype 3,” commented Dr. Di Bisceglie. The results
are summarized in Figure 5. Among patients with genotype 2, the SVR was 65% at 16
weeks and 82% at 24 weeks. Among patients with genotype 3, the SVR was 65% at 16
weeks and 71% at 24 weeks. Remarked Dr.Di Bisceglie, “Treatment response rates were
consistently lower with 16 weeks of treatment.”
Hector
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
"...the ACCELERATE trial, was coauthored by Dr. Shiffman.15 “It is
the largest of the four studies and included 1,469 patients with genotypes 2 and 3,” observed
Dr. Di Bisceglie. The patients were randomized to receive PEG-IFN alfa-2a plus
ribavirin for either 16 or 24 weeks. “This study was large enough to allow us to compare
responses in genotype 2 and genotype 3,” commented Dr. Di Bisceglie. The results
are summarized in Figure 5. Among patients with genotype 2, the SVR was 65% at 16
weeks and 82% at 24 weeks. Among patients with genotype 3, the SVR was 65% at 16
weeks and 71% at 24 weeks. Remarked Dr.Di Bisceglie, “Treatment response rates were
consistently lower with 16 weeks of treatment.”
Hector
I'm a geno 2 who was UND at 4 weeks and then, due to severe sides, was pulled off riba after only 12 weeks, took an additional week of INF alone, and am SVR. It's been over a year now, so I'm 99.999% sure that I'll never see the hep c virus again.
But in general, if you can tolerate the sides, it's always better to go the full 24 weeks. I forget the exact percentages, but it's something like 90% at 24 weeks (with an UND at the 4th week of tx) versus 82% with a 16 week tx. BTW, I was 63 years old and had a moderate viral load (1,250,000), so i'm really lucky. I would have gone longer, but the doctor wouldn't let me.
But in general, if you can tolerate the sides, it's always better to go the full 24 weeks. I forget the exact percentages, but it's something like 90% at 24 weeks (with an UND at the 4th week of tx) versus 82% with a 16 week tx. BTW, I was 63 years old and had a moderate viral load (1,250,000), so i'm really lucky. I would have gone longer, but the doctor wouldn't let me.
What was your baseline viral load? High or low? I think that is the question that needs to be answered. I read something about geno 2 and 3 rapid responders with low viral loads (below 400'000 IU/ml) allowed to go only 16 weeks in Europe. It was a thread here not long ago. See if you can find it in the archives.
Ladybug was a geno 2,cleared at 2 weeks, stopped at 16 and is SVR.
Whether that will work for you or not is a toss up.
Listen to your intuition.
Whether that will work for you or not is a toss up.
Listen to your intuition.
There has been some discussion that it is possible for some people to do 16 week TX.
But there isn't enough data on it yet for me to be sure.
There is a chance - and it might be a good chance --- that you could clear the virus at that point.
But there is also a chance that it might be just not enough --- barely.
For me - there is no way I am going to do this TX a second time.
Sorry -- just not gonna do it.
Each person must totally choose for themselves.
Much luck to you.
Meki
PS. being UND at week 2 -- is an AWESOME start.
How are you doing on other sides?
But there isn't enough data on it yet for me to be sure.
There is a chance - and it might be a good chance --- that you could clear the virus at that point.
But there is also a chance that it might be just not enough --- barely.
For me - there is no way I am going to do this TX a second time.
Sorry -- just not gonna do it.
Each person must totally choose for themselves.
Much luck to you.
Meki
PS. being UND at week 2 -- is an AWESOME start.
How are you doing on other sides?
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