I live in Canada, should I wait for protease inhibitor approval?
CanadaHep said
Jun 16, 2011
Thank you everyone for the replies and wishes of good luck. Good luck to all of you also!
I am starting my treatments Tuesday. Here's hoping it works. *crosses fingers*
BJ said
May 31, 2011
Gidday Everyone,
I remember before my little trip down the tx path, we seed and sawed back and forth over issues like would we wait and see if bocep would get cleared or perhaps trial spots open up etc; etc; and then common sense came back and I started my SOC journey.
You made the right decision Randy. You'll have that virus wrapped up and well and truly wooped looong before any of these inhibitors become available to guys like you.
Same goes for you there CanadaHep. The SOC drugs whup the virus fine for geno 2's so as soon as you get the funding, I'd get stuck into tx and get it over with like Randy did. If you are worried about mutations, the new inhibitors are more of a concern there, and besides, someone with such a recent infection as yourself and Geno 2 as well would clean the virus very effectively using current tx.
Point of interest:- I had a scan of my liver and kidneys, for reasons other than HepC, less than a year before being diagnosed HepC positive. I'd carried the virus for 30 years and the scan said my liver was clean:) 18 months later a liver biopsy showed badly infected liver with level 2/3 Fibrosis !! If you've got HepC, your liver is in serious trouble - regardless of how long you've been infected.
Cheers.
Brendan.
Hep Me said
May 31, 2011
Hey CanadaHep, welcome to the forum. I am geno 2 with little scarring also and am over halfway through a 24 wk treatment (tx) using pegintron and riva. I think I read that the first recipients of the new drug would be those who have harder time with tx - geno 1 for instance to cut down the 48 wk tx time. I don't know all the whys and whens of it, just what I read. Before I read that, I was wondering the same thing as you, if maybe I should wait for the new drugs. I finally decided I wanted this over and done with asap and so I started as soon as I could. Take care, Randy
Greg said
May 31, 2011
Hi CanadaHep,
Great link thank you for posting, just like to wish you all the best when you start treatment. Cheers, Greg
ty said
May 30, 2011
Very interesting study, thank you for the info!
Some interesting things pop out:
It is a very small "N", (number of participants) for a study this broad. When you disaggregate the scores the numbers become too small to show statistically significant findings. That probably means that the researchers are probably just looking for patterns and intend this particular study will lead to a much larger study in the future.
It is this type of early study that gets you the research money to continue with what has become very expensive and very time consuming due to government rules and regulations. ( Not that I'm against them, but it has added a whole new problem to what should be pure research. The idea that research leads to profits, etc.)
The researchers are well known and the schools are top notch, this information will surely lead to further studies.
The numbers for attaining SVR with Interferon and Ribavirin in the type 3's seem lower than other studies I have read. If these are true (and scores that differ from commonly accepted research are generally a good thing, they tend to show researcher integrity), then that's where the next tranch of money will be directed.
The 100% SVR for type 2's (with all three drugs)is certainly not possible in any very large study. It's just statistically not possible, there are simply too many variables. (oh well...) I'm assuming it will raise the numbers who reach SVR, but then it will become part of a cost/benefit study.
It's very interesting, there are some awards to be won (and some money to be made) in the field of Hep C research. Thanks again, ty
-- Edited by ty on Tuesday 31st of May 2011 12:53:59 AM
James10500 said
May 30, 2011
Wow 100% SVR for triple arm treatment with tela for g-2's thanks for the study. Why take any chances I'm a G-2 finished treatment 1/27/11 I would have waited although my liver was stage three, doc says I should start right away. Also in Aug '10 one of my docs said he'd been hearing for years about Tela getting approved and it never had so he said you really can't tell. There is a thread on Tela and Boce with youtube clips from Dr. Palmer describing the treatment, very important not to miss a dose and the timing needs to be exact. Here is the video http://www.youtube.com/watch?v=xiCcSxdyq7A&feature=mfu_in_order&list=UL
Good luck,
James
CanadaHep said
May 30, 2011
Hi Ty and Ron, thanks for your replies.
Ty, here is a Phase 2a study where Telaprevir was used in conjuction with Interferon and Ribavirin on patients with Genotype 2 who previously did not receive treatment.
However, I did not know that these protease inhibitors were only approved to treat Genotype I Hep C. That changes things a lot. Thanks for your help.
-- Edited by CanadaHep on Monday 30th of May 2011 11:33:49 PM
Ron Gilbert said
May 30, 2011
Hi Ty, thanks for making that more clear.
I didn't think there was an advantage for Geno 2 to take the new drugs..... but for all I knew they were giving it to everyone. Daaa, goes to show you what I know. lol.
ty said
May 30, 2011
Hi CanadaHep,
Welcome to the forum! All of the research that I have read has been using the new drugs to treat genotype 1. They both increase the cure rates and shorten the time (48 weeks) that people would need to be on treatment. Either one or the other is used in conjunction with Interferon and Ribavirin.
Type 2's are using Interferon and Ribavirin for 24 weeks and this is the Standard of Care, (SOC) throughout the world. I have never heard of any mutations such as you describe. Before any of the new drugs could be used on genotypes other than 1's they would need a few years of research, I assume.
It's a positive thing that you are getting approval for the tx and also very positive that your liver looks good. I don't think I would wait. Take care, ty
Ron Gilbert said
May 30, 2011
Hi Canada,
The available tx of Riba and Peg. Interferon is quite effective on Genotype 2 HCV to the best of my knowledge. I don't see the advantage except for those with Genotype 1. The idea is to reach undetected as early as posible during tx. Those of us with Geno 1 often dont get there til week 12 or even 24 which means we have to continue tx for 48 weeks to try and ensure eradication. While Geno 2 most often get there at week 4 (UND) and only do 24 weeks of treatment total. The Riba dose is even reduced in your case making it a bit easier.
Hope this helps. Ron
-- Edited by Ron Gilbert on Monday 30th of May 2011 11:23:38 PM
CanadaHep said
May 30, 2011
I have Genotype 2 Hepatitic C and have not been treated for it. I have had an ultrasound done with no detectable scarring. I live a clean life and only contracted the disease about a year ago.
I live in Canada. I have heard Boceprevir could be approved in Canada by the end of the year. I only asked about Boceprevir, I assume Telaprevir approval would come around the same time. I am currently waiting on funding to start treatments of Interferon + Ribavirin, which I expect I will be approved for shortly.
My main concern is to beat the disease. Is there any risk (i.e. increased risk of mutations) in doing the currently approved treatments in Canada, which should these mutations occur would then lessen ones chances of beating the disease using Interferon + Ribavirin + Boceprevir?
Does anyone think it's in my best interest to wait until a protease inhibitor is available to me before starting treatment?
-- Edited by CanadaHep on Monday 30th of May 2011 10:41:24 PM
-- Edited by CanadaHep on Monday 30th of May 2011 10:50:30 PM
Thank you everyone for the replies and wishes of good luck. Good luck to all of you also!
I am starting my treatments Tuesday. Here's hoping it works. *crosses fingers*
Gidday Everyone,
I remember before my little trip down the tx path, we seed and sawed back and forth over issues like would we wait and see if bocep would get cleared or perhaps trial spots open up etc; etc; and then common sense came back and I started my SOC journey.
You made the right decision Randy.
You'll have that virus wrapped up and well and truly wooped looong before any of these inhibitors become available to guys like you.
Same goes for you there CanadaHep. The SOC drugs whup the virus fine for geno 2's so as soon as you get the funding, I'd get stuck into tx and get it over with like Randy did. If you are worried about mutations, the new inhibitors are more of a concern there, and besides, someone with such a recent infection as yourself and Geno 2 as well would clean the virus very effectively using current tx.
Point of interest:- I had a scan of my liver and kidneys, for reasons other than HepC, less than a year before being diagnosed HepC positive. I'd carried the virus for 30 years and the scan said my liver was clean:) 18 months later a liver biopsy showed badly infected liver with level 2/3 Fibrosis !! If you've got HepC, your liver is in serious trouble - regardless of how long you've been infected.
Cheers.
Brendan.
Hey CanadaHep, welcome to the forum. I am geno 2 with little scarring also and am over halfway through a 24 wk treatment (tx) using pegintron and riva. I think I read that the first recipients of the new drug would be those who have harder time with tx - geno 1 for instance to cut down the 48 wk tx time. I don't know all the whys and whens of it, just what I read. Before I read that, I was wondering the same thing as you, if maybe I should wait for the new drugs. I finally decided I wanted this over and done with asap and so I started as soon as I could.
Take care,
Randy
Hi CanadaHep,
Great link thank you for posting, just like to wish you all the best when you start treatment.
Cheers,
Greg
Very interesting study, thank you for the info!
Some interesting things pop out:
It is a very small "N", (number of participants) for a study this broad. When you disaggregate the scores the numbers become too small to show statistically significant findings. That probably means that the researchers are probably just looking for patterns and intend this particular study will lead to a much larger study in the future.
It is this type of early study that gets you the research money to continue with what has become very expensive and very time consuming due to government rules and regulations. ( Not that I'm against them, but it has added a whole new problem to what should be pure research. The idea that research leads to profits, etc.)
The researchers are well known and the schools are top notch, this information will surely lead to further studies.
The numbers for attaining SVR with Interferon and Ribavirin in the type 3's seem lower than other studies I have read. If these are true (and scores that differ from commonly accepted research are generally a good thing, they tend to show researcher integrity), then that's where the next tranch of money will be directed.
The 100% SVR for type 2's (with all three drugs)is certainly not possible in any very large study. It's just statistically not possible, there are simply too many variables. (oh well...) I'm assuming it will raise the numbers who reach SVR, but then it will become part of a cost/benefit study.
It's very interesting, there are some awards to be won (and some money to be made) in the field of Hep C research. Thanks again, ty
-- Edited by ty on Tuesday 31st of May 2011 12:53:59 AM
Good luck,
James
Hi Ty and Ron, thanks for your replies.
Ty, here is a Phase 2a study where Telaprevir was used in conjuction with Interferon and Ribavirin on patients with Genotype 2 who previously did not receive treatment.
http://www.hivandhepatitis.com/2010_conference/easl/docs/0514_2010_b.html
However, I did not know that these protease inhibitors were only approved to treat Genotype I Hep C. That changes things a lot. Thanks for your help.
-- Edited by CanadaHep on Monday 30th of May 2011 11:33:49 PM
Hi Ty, thanks for making that more clear.
I didn't think there was an advantage for Geno 2 to take the new drugs..... but for all I knew they were giving it to everyone. Daaa, goes to show you what I know. lol.
Hi CanadaHep,
Welcome to the forum! All of the research that I have read has been using the new drugs to treat genotype 1. They both increase the cure rates and shorten the time (48 weeks) that people would need to be on treatment. Either one or the other is used in conjunction with Interferon and Ribavirin.
Type 2's are using Interferon and Ribavirin for 24 weeks and this is the Standard of Care, (SOC) throughout the world. I have never heard of any mutations such as you describe. Before any of the new drugs could be used on genotypes other than 1's they would need a few years of research, I assume.
It's a positive thing that you are getting approval for the tx and also very positive that your liver looks good. I don't think I would wait. Take care, ty
Hi Canada,
The available tx of Riba and Peg. Interferon is quite effective on Genotype 2 HCV to the best of my knowledge. I don't see the advantage except for those with Genotype 1. The idea is to reach undetected as early as posible during tx. Those of us with Geno 1 often dont get there til week 12 or even 24 which means we have to continue tx for 48 weeks to try and ensure eradication. While Geno 2 most often get there at week 4 (UND) and only do 24 weeks of treatment total. The Riba dose is even reduced in your case making it a bit easier.
Hope this helps. Ron
-- Edited by Ron Gilbert on Monday 30th of May 2011 11:23:38 PM
I have Genotype 2 Hepatitic C and have not been treated for it. I have had an ultrasound done with no detectable scarring. I live a clean life and only contracted the disease about a year ago.
I live in Canada. I have heard Boceprevir could be approved in Canada by the end of the year. I only asked about Boceprevir, I assume Telaprevir approval would come around the same time. I am currently waiting on funding to start treatments of Interferon + Ribavirin, which I expect I will be approved for shortly.
My main concern is to beat the disease. Is there any risk (i.e. increased risk of mutations) in doing the currently approved treatments in Canada, which should these mutations occur would then lessen ones chances of beating the disease using Interferon + Ribavirin + Boceprevir?
Does anyone think it's in my best interest to wait until a protease inhibitor is available to me before starting treatment?
-- Edited by CanadaHep on Monday 30th of May 2011 10:41:24 PM
-- Edited by CanadaHep on Monday 30th of May 2011 10:50:30 PM