New HCV Treatment Guidelines from US medical societies, including `off label` recommendations.
Tig said
Jan 30, 2014
Jill, I'm sure you're right, they won't give the patient the option to change their course of treatment to a different regimen. They're too invested in it to risk the backlash of unhappy customers by suddenly recommending a change in medication. However, they don't have a problem reducing or raising dosages of these meds to customize responses, so the principle could be considered similar, imo. I think the option should be considered if requested, particularly after releasing a statement "advising against regimens containing the first-generation HCV protease inhibitors boceprevir (Victrelis) or telaprevir (Incivo)". I believe better consideration should've been given before making a blanket statement like that. As you mentioned, the use of these old treatments will be ongoing for years to come. But in light of these reports and statements from one of the leading US medical societies, the possibility of patients refusing to take these treatments because of their comments could be noteable indeed. To me personally, the only thing ill advised was their statement at this point of the process. I'm very disappointed with their decision.
Tig
Cinnamon Girl said
Jan 30, 2014
Hi Tig, I can`t actually imagine that anyone would be given the option to change treatments once they`d started with Peg/Riba or a first generation PI triple therapy, and whenever new drug options become available there are always people still in the process of doing previously recommended drug regimens, there`s no way to avoid that. There will still be a need for these `old` treatments for quite a while to come yet in many parts of the world, and of course the cost will be a consideration too.
Tig said
Jan 30, 2014
Thanks for posting that information Jill, it's very informative. I'm concerned about one of the statements in that article though.
The panel stated; "For almost all patients, the panel specifically recommends against the old standard of care, pegylated interferon plus ribavirin alone. They also advise against regimens containing the first-generation HCV protease inhibitors boceprevir (Victrelis) or telaprevir (Incivo), which can improve cure rates compared to interferon/ribavirin alone but come with added side-effects and potential for drug interactions".
This kind of release is bound to cause confusion and uncertainty in all of the patients currently underway with the "old" triple therapies with Peg/Riba and one of the protease inhibitors. I hope in light of that the "Industry", be it medical or insurance, considers the ramifications of such a statement. Why continue to endorse/prescribe the continuation of a therapy that they have suddenly decided (advised) is inadequate? Hopefully consideration will be given to these people to change treatment regimens if desired. It would be an easy decision for me. This really opens up a new can of worms...
Tig
longld said
Jan 30, 2014
A quick review of this shows that Sovaldi has quickly come to the forefront for almost all treatment regimens. Also, for those in the US that have been proposing a single-payer health system please note the comments on the cost considerations in Europe; 'European advocates have expressed concern that patients may be required to start with less effective and poorly tolerated interferon-based regimens due to their lower cost.' off my political stool now.......sorry
lauralou57 said
Jan 30, 2014
Many thanks for posting this!
I had heard these guidelines were coming out and have been looking for them.
Cinnamon Girl said
Jan 30, 2014
US medical societies launch new hepatitis C treatment guidelines
`The American Association for the Study of Liver Diseases (AASLD), Infectious Diseases Society of America (IDSA) and International Antiviral Society-USA (IAS-USA) yesterday announced the first new hepatitis C treatment guidelines to include next-generation direct-acting antiviral agents recently approved by the US Food and Drug Administration (FDA). The guidance, available on the newly launched website HCVguidelines.org, will be updated frequently to reflect emerging data.`
`The new guidelines were developed by a panel of 27 liver disease and infectious diseases specialists and a patient advocate. The evidence-based consensus recommendations reflect the latest data on screening, management and treatment of chronic hepatitis C.`
The guidelines include treatment recommendations for initial therapy for all genotypes of HCV, for previous non-responders, and for people with HCV/HIV co-infection.
Jill, I'm sure you're right, they won't give the patient the option to change their course of treatment to a different regimen. They're too invested in it to risk the backlash of unhappy customers by suddenly recommending a change in medication. However, they don't have a problem reducing or raising dosages of these meds to customize responses, so the principle could be considered similar, imo. I think the option should be considered if requested, particularly after releasing a statement "advising against regimens containing the first-generation HCV protease inhibitors boceprevir (Victrelis) or telaprevir (Incivo)". I believe better consideration should've been given before making a blanket statement like that. As you mentioned, the use of these old treatments will be ongoing for years to come. But in light of these reports and statements from one of the leading US medical societies, the possibility of patients refusing to take these treatments because of their comments could be noteable indeed. To me personally, the only thing ill advised was their statement at this point of the process. I'm very disappointed with their decision.
Tig
Hi Tig, I can`t actually imagine that anyone would be given the option to change treatments once they`d started with Peg/Riba or a first generation PI triple therapy, and whenever new drug options become available there are always people still in the process of doing previously recommended drug regimens, there`s no way to avoid that. There will still be a need for these `old` treatments for quite a while to come yet in many parts of the world, and of course the cost will be a consideration too.
Thanks for posting that information Jill, it's very informative. I'm concerned about one of the statements in that article though.
The panel stated; "For almost all patients, the panel specifically recommends against the old standard of care, pegylated interferon plus ribavirin alone. They also advise against regimens containing the first-generation HCV protease inhibitors boceprevir (Victrelis) or telaprevir (Incivo), which can improve cure rates compared to interferon/ribavirin alone but come with added side-effects and potential for drug interactions".
This kind of release is bound to cause confusion and uncertainty in all of the patients currently underway with the "old" triple therapies with Peg/Riba and one of the protease inhibitors. I hope in light of that the "Industry", be it medical or insurance, considers the ramifications of such a statement. Why continue to endorse/prescribe the continuation of a therapy that they have suddenly decided (advised) is inadequate? Hopefully consideration will be given to these people to change treatment regimens if desired. It would be an easy decision for me. This really opens up a new can of worms...
Tig
Many thanks for posting this!
I had heard these guidelines were coming out and have been looking for them.
US medical societies launch new hepatitis C treatment guidelines
`The American Association for the Study of Liver Diseases (AASLD), Infectious Diseases Society of America (IDSA) and International Antiviral Society-USA (IAS-USA) yesterday announced the first new hepatitis C treatment guidelines to include next-generation direct-acting antiviral agents recently approved by the US Food and Drug Administration (FDA). The guidance, available on the newly launched website HCVguidelines.org, will be updated frequently to reflect emerging data.`
`The new guidelines were developed by a panel of 27 liver disease and infectious diseases specialists and a patient advocate. The evidence-based consensus recommendations reflect the latest data on screening, management and treatment of chronic hepatitis C.`
The guidelines include treatment recommendations for initial therapy for all genotypes of HCV, for previous non-responders, and for people with HCV/HIV co-infection.
Full article...
http://www.aidsmap.com/US-medical-societies-launch-new-hepatitis-C-treatment-guidelines/page/2822890/