Study suggests unprecedented 3-week HCV Cure

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9 November 2015 at 2:58 am #3528
Dr James
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@fixhepc
So this is really interesting:

http://news.sciencemag.org/health/2015/10/study-suggests-unprecedented-3-week-hepatitis-c-cure

But it throws the notion of patient selection for trial entry into stark relief. See LB-23 here:

http://www.aasld.org/sites/default/files/TLM-2015-LakeBreakingAbstracts.pdf

26 subjects with GT 1b (the easiest to treat) started, then the 18 with exceptional RVR were put into the trial.

It makes for a great headline, but it’s worth noting that 8/26 were excluded and just did usual treatment length treatment.

When reading trial data it’s important to read the fine print before deciding if the treatment population was a good match for your genetics and genotype.

YMMV
9 November 2015 at 2:42 pm #3560
dointime
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@dointime
“26 subjects with GT 1b (the easiest to treat)”

Hi Doc Freeman,
Do you have any links that show that GT 1b is the easiest to treat?
I am 1b. In the Gilead ION2 trial the subtype 1b came out significantly worse than the 1a.
There were only 23 people who were 1b so maybe this is just an example of the sample size being too small. However I asked my doc and he also seemed to think that 1a had a better chance with Harvoni than 1b.

On the subject of subtypes, the UK NHS don’t even test for subtype these days, so people don’t know. I only know mine because it was tested when I did a trial.

Thanks,
dt
9 November 2015 at 3:53 pm #3565
Dr James
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Yes start at the beginning with:

ION-3

ION-3 was a randomized, open-label trial in treatment-naïve non-cirrhotic subjects with genotype 1 CHC. Subjects were randomized in a 1:1:1 ratio to one of the following three treatment groups and stratified by HCV genotype (1a vs 1b): Harvoni for 8 weeks, Harvoni for 12 weeks, or Harvoni + ribavirin for 8 weeks. The SVR rate was 94% and 96% for the Harvoni 8 and 12-week duration arms, respectively. Ribavirin was not shown to increase the response rates observed with Harvoni. By genotype the SVR rates were: Genotype 1a 93% (8 wks) and 96% (12 wks) and Genotype 1b 98% for both 8 and 12 weeks.

And then check:

http://www.uptodate.com/contents/treatment-regimens-for-chronic-hepatitis-c-virus-genotype-1

YMMV
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