Interesting topic, having taken Ribavirin with my 24 week Harvoni protocol, I would agree with not taking it. But when you are talking about dealing with relapsed patients and cirrhotics and the increased percentage of 1 or 2 percent being a benefit or a greater chance of achieving SVR a large percentage would choose it because of not wanting the leave anything on the table.
I think the future treatments will not include Riba, because they will get better and better with less side effects and less duration, and hopefully less expensive.
matt
Groupergetter said
Jul 3, 2015
I'm still hoping my 12 week eot labs come back UND. Twice I asked my doc about taking Riba with the Harvoni as the discussion by docs at the AASLD convention recommend the Riba to afford additional protection for those with cirrhosis. Twice I was told no. While I wasn't overjoyed by the prospect of adding Riba I would have gladly done so if it helped kill this beast. This data seems to support the Riba isn't necessary. Hope all have a Happy and Safe 4th of July. Yes Duane we're praying for you.
robertsamx said
Jul 3, 2015
With the drug combos avalable today, I.M.O. all type 3"s should ask to have riba added to there treatment if at all possible. And I.M.O. all 3:s with cirrhosis must and should have riba. This is all backed up with trial results. RC
Cinnamon Girl said
Jul 3, 2015
Yes I know that, Brian, it was a good question.
Thanks
Brian1412 said
Jul 3, 2015
Was just courious. Wasnt suggesting they should
Cinnamon Girl said
Jul 3, 2015
No, not at all, Brian. Anyone who has been prescribed ribavirin along with Harvoni should continue to take it.
Thanks.
Brian1412 said
Jul 3, 2015
So what happens to those on riba? They drop it?
Brian1412 said
Jul 3, 2015
Does this mean thst will never ever have a chance to take that drug...if so thank god
Cinnamon Girl said
Jul 3, 2015
Thanks for the post, Pamelamean, I was reading an article about this earlier and here`s the link..
Most people who are prescribed Harvoni aren`t actually given ribavirin as an additional drug anyway, it`s only considered necessary for certain `harder to treat` categories of patients, but it`s good to know this.
Conclusion from the study authors....
"[Sofosbuvir/ledipasvir] plus ribavirin was associated with a greater incidence of adverse events as well as concomitant medication use than [sofosbuvir/ledipasvir] alone," the study authors concluded. "Use of ribavirin did not impact the efficacy of [sofosbuvir/ledipasvir] regimens in the ION Phase III studies."
"While the overall SVR rates with and without ribavirin were the same in these studies -- in which a majority of participants were treatment-naive and did not have cirrhosis -- ribavirin may still have a role to play in treating the most challenging patients."
No-one wants to have to endure the side effects of ribavrin unless really necessary, as those of us who have been through it can testify, but we`re not quite at the stage where we can say goodbye to this drug yet, unfortunately!
Scruffy said
Jul 3, 2015
Thats great news. Looks like the end of tx with riba. Glad to see that. My 48 weeks with riba sucked big time but I won't complain cause I cleared the virus. That was the latest and greatest when I did my TX.
pamelajean said
Jul 3, 2015
New Hepatitis C Treatment Needs No Antiviral Boost
Release Date: July 1, 2015
FAST FACTS: A study of nearly 2,000 patients showed that adding ribavirin to the combination of ledipasvir and sofosbuvir had no benefit in treating hepatitis C.
Patients taking ribavirin along with the combination were more likely to have adverse side effects to the treatment.
The drug approved to treat patients infected with the hepatitis C virus needs no help from other antivirals, according to a study released online this week in the journal Hepatology.
Adding the antiviral drug ribavirin to the fixed-dose combination of viral inhibtor ledipasvir and nucleotide inhibitor sofosbuvir offered no better result than ledipasvir/sofosbuvir alone, says a study led by Saleh Alqahtani, M.D., and Mark Sulkowski, M.D., of the Johns Hopkins University School of Medicine. In fact, say the studys authors, the ribavirin combination was associated with a higher rate of adverse events.
Analyzing data from nearly 2,000 patients taking ledipasvir/sofosbuvir to clear their systems of hepatitis C, the studys authors compared patients who were prescribed only the ledipasvir/sofosbuvir fixed-dose tablet with patients whose physicians added ribavirin to the ledipasvir/sofosbuvir treatment regimen.
Were in the very early days of prescribing this medication, says Alqahtani, director of clinical liver research at Johns Hopkins. We learn more about it all the time. This study should put to rest the notion that ledipasvir and sofosbuvir need a boost from ribavirin.
Both sets of patients showed 97 percent viral clearance success rates. But 71 percent of patients whose regimens included ribavirin experienced adverse events related to their treatment. While less than 1 percent of the adverse reactions were severe, the 71 percent did experience symptoms like fatigue, insomnia, irritability and a skin rash. Of the patients taking only ledipasvir/sofosbuvir, 45 percent had similar reactions. Patients taking ribavirin were also more likely to need interruptions to their medication regime to resolve their complications.
The combination of ledipasvir and sofosbuvir was approved for treatment of hepatitis C by the Food and Drug Administration only last fall. The medication is a new way to treat a viral disease that causes slow liver damage and has killed millions of people around the world.
Prior to the emergence of ledipasvir and sofosbuvir, the standard of care to treat hepatitis C was the antiviral drug ribavirin, prescribed alongside interferon. Medication regimens were long, serious side effects were nearly universal and the rates of sustained viral response varied.
Ribavirin had a real place when we fought hepatitis C with interferon, says Alqahtani. But as care for patients with hepatitis C evolves, this study shows that it no longer offers a benefit.
In addition to Alqahtani and Sulkowski, the studys authors are Nazam Afdal of Beth Israel Deaconess Hospital in Boston; Stefan Zeuzem of Johann Wolfgang Goethe University in Franfurt; Stuart C. Gordon of the Henry Ford Health System in Detroit; Alessandra Mangia of Casa Sollievo della Sofferenza Hospital in Italy; Paul Kwo of Indiana University, Michael Fried of the University of North Carolina; Jenny C. Yang, Xiao Ding, Phillip S. Pang and John G. McHutchinson of Gilead Sciences in California; David Pound of the Indianapolis Gastroenterology Research Foundation; K. Rajender Reddy of the University of Pennsylvania; Patrick Marcellin of the Centre Hospitalier Universitaire Beaujon in France; and Kris V. Kowdley of the Swedish Medical Center in Seattle.
Funding and drugs for the studies described in the Hepatology article were provided by Gilead Sciences. Drs. Sulkowski and Alqahtani were both paid advisory board members for Gilead Sciences. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.
Interesting topic, having taken Ribavirin with my 24 week Harvoni protocol, I would agree with not taking it. But when you are talking about dealing with relapsed patients and cirrhotics and the increased percentage of 1 or 2 percent being a benefit or a greater chance of achieving SVR a large percentage would choose it because of not wanting the leave anything on the table.
I think the future treatments will not include Riba, because they will get better and better with less side effects and less duration, and hopefully less expensive.
matt
I'm still hoping my 12 week eot labs come back UND. Twice I asked my doc about taking Riba with the Harvoni as the discussion by docs at the AASLD convention recommend the Riba to afford additional protection for those with cirrhosis. Twice I was told no. While I wasn't overjoyed by the prospect of adding Riba I would have gladly done so if it helped kill this beast. This data seems to support the Riba isn't necessary. Hope all have a Happy and Safe 4th of July. Yes Duane we're praying for you.
With the drug combos avalable today, I.M.O. all type 3"s should ask to have riba added to there treatment if at all possible. And I.M.O. all 3:s with cirrhosis must and should have riba. This is all backed up with trial results. RC
Yes I know that, Brian, it was a good question.
Thanks
Was just courious. Wasnt suggesting they should
No, not at all, Brian. Anyone who has been prescribed ribavirin along with Harvoni should continue to take it.
Thanks.
So what happens to those on riba? They drop it?
Does this mean thst will never ever have a chance to take that drug...if so thank god
Thanks for the post, Pamelamean, I was reading an article about this earlier and here`s the link..
http://hivandhepatitis.org/hcv-treatment/approved-hcv-drugs/5261-adding-ribavirin-to-harvoni-for-hepatitis-c-increases-side-effects-but-not-efficacy
Most people who are prescribed Harvoni aren`t actually given ribavirin as an additional drug anyway, it`s only considered necessary for certain `harder to treat` categories of patients, but it`s good to know this.
Conclusion from the study authors....
"[Sofosbuvir/ledipasvir] plus ribavirin was associated with a greater incidence of adverse events as well as concomitant medication use than [sofosbuvir/ledipasvir] alone," the study authors concluded. "Use of ribavirin did not impact the efficacy of [sofosbuvir/ledipasvir] regimens in the ION Phase III studies."
"While the overall SVR rates with and without ribavirin were the same in these studies -- in which a majority of participants were treatment-naive and did not have cirrhosis -- ribavirin may still have a role to play in treating the most challenging patients."
No-one wants to have to endure the side effects of ribavrin unless really necessary, as those of us who have been through it can testify, but we`re not quite at the stage where we can say goodbye to this drug yet, unfortunately!
Thats great news. Looks like the end of tx with riba. Glad to see that. My 48 weeks with riba sucked big time but I won't complain cause I cleared the virus. That was the latest and greatest when I did my TX.
New Hepatitis C Treatment Needs No Antiviral Boost
Release Date: July 1, 2015
FAST FACTS:
A study of nearly 2,000 patients showed that adding ribavirin to the combination of ledipasvir and sofosbuvir had no benefit in treating hepatitis C.
The drug approved to treat patients infected with the hepatitis C virus needs no help from other antivirals, according to a study released online this week in the journal Hepatology.
Adding the antiviral drug ribavirin to the fixed-dose combination of viral inhibtor ledipasvir and nucleotide inhibitor sofosbuvir offered no better result than ledipasvir/sofosbuvir alone, says a study led by Saleh Alqahtani, M.D., and Mark Sulkowski, M.D., of the Johns Hopkins University School of Medicine. In fact, say the studys authors, the ribavirin combination was associated with a higher rate of adverse events.
Analyzing data from nearly 2,000 patients taking ledipasvir/sofosbuvir to clear their systems of hepatitis C, the studys authors compared patients who were prescribed only the ledipasvir/sofosbuvir fixed-dose tablet with patients whose physicians added ribavirin to the ledipasvir/sofosbuvir treatment regimen.
Were in the very early days of prescribing this medication, says Alqahtani, director of clinical liver research at Johns Hopkins. We learn more about it all the time. This study should put to rest the notion that ledipasvir and sofosbuvir need a boost from ribavirin.
Both sets of patients showed 97 percent viral clearance success rates. But 71 percent of patients whose regimens included ribavirin experienced adverse events related to their treatment. While less than 1 percent of the adverse reactions were severe, the 71 percent did experience symptoms like fatigue, insomnia, irritability and a skin rash. Of the patients taking only ledipasvir/sofosbuvir, 45 percent had similar reactions. Patients taking ribavirin were also more likely to need interruptions to their medication regime to resolve their complications.
The combination of ledipasvir and sofosbuvir was approved for treatment of hepatitis C by the Food and Drug Administration only last fall. The medication is a new way to treat a viral disease that causes slow liver damage and has killed millions of people around the world.
Prior to the emergence of ledipasvir and sofosbuvir, the standard of care to treat hepatitis C was the antiviral drug ribavirin, prescribed alongside interferon. Medication regimens were long, serious side effects were nearly universal and the rates of sustained viral response varied.
Ribavirin had a real place when we fought hepatitis C with interferon, says Alqahtani. But as care for patients with hepatitis C evolves, this study shows that it no longer offers a benefit.
In addition to Alqahtani and Sulkowski, the studys authors are Nazam Afdal of Beth Israel Deaconess Hospital in Boston; Stefan Zeuzem of Johann Wolfgang Goethe University in Franfurt; Stuart C. Gordon of the Henry Ford Health System in Detroit; Alessandra Mangia of Casa Sollievo della Sofferenza Hospital in Italy; Paul Kwo of Indiana University, Michael Fried of the University of North Carolina; Jenny C. Yang, Xiao Ding, Phillip S. Pang and John G. McHutchinson of Gilead Sciences in California; David Pound of the Indianapolis Gastroenterology Research Foundation; K. Rajender Reddy of the University of Pennsylvania; Patrick Marcellin of the Centre Hospitalier Universitaire Beaujon in France; and Kris V. Kowdley of the Swedish Medical Center in Seattle.
Funding and drugs for the studies described in the Hepatology article were provided by Gilead Sciences. Drs. Sulkowski and Alqahtani were both paid advisory board members for Gilead Sciences. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.