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TOPIC: Sof+Led vs Sof+Dac - and the winner is.....

Sof+Led vs Sof+Dac - and the winner is..... 3 years 4 months ago #8062

  • DrJames
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Here are the available studies as they relate to GT1 and Sof+Led (Harvoni) vs Sof+Dac (Sovaldi + Dalinza)

Sof+Dac

GT1 ALLY-2 naive (80/83) experienced (43/44) Aggregate 96.8% (123/127)
GT1a ALLY-2 naive 96% (68/71) experienced 97% (32/33) Aggregate 96.2% (100/104)
GT1b ALLY-2 ALLY-2 naive 100% (12/12) experienced 100% (11/11) Aggregate 100% (23/23)
F4 ALLY-2 naive 89% (8/9) experienced 92% (12/13) Aggregate 90.9% (20/22)
Past Failure ALLY-2 98% (43/44)

Sof+Led

GT1 ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)
GT1a ION-1 98% (142/145) ION-3 96% 96% (165/172) Aggregate 96.8% (307/317)
GT1b ION-1 100% (67/67) ION-3 98% (43/44) Aggregate 99.1% (110/111)
F4 ION-1 97% (32/33)
Past Failure ON-3 94% (102/109)

Not a lot between them, but the data for Sof+Led is more robust due to better n

I would be happy taking either. Sof+Dac is a better choice if taking antacid type medications because Ledipasvir needs acid for absorption.
YMMV
Last Edit: 3 years 4 months ago by DrJames.
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 4 months ago #8086

  • darbara
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What acid does Ledipasvir need ?
Treatment naive
F 3/4
Genotype 1 a & b
V/L 17 MILLION
Started Harvoni 11th Dec 2015 for 12 weeks
4 weeks VL UND
6 WEEKS ALT 32, AST 34
EOT 03/03 2016 ! UND
ALT 34, AST 26
04.04.2016 SVR 4
26.05.2016 SVR 12
16.08.2016 SVR 24
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 4 months ago #8101

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Stomach acid in which some have too much hence the use of antacids etc.
Diagnosed Hep C 2013
Geno Type: 1a
Treatment: Naïve
Cirrhosis
F4
2015 GGT 227 AST 79 ALT 89 Platelets 88
2016 Treatment Generic Harvoni Finished 29 March 2016
GGT 30 AST 19 ALP 67 Platelets 91
Qualitative Test Results April 12
Hepatitis C NAT (NA): Not Detected
P.C.R Test for Hep C 4th July: Negative
Virus Free
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 1 month ago #14608

  • tweakmax
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Do u have led vs dac data for redemption trial doc? Both equal in efficacy?
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 1 month ago #14617

  • klhilde
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If I understood correctly, Dac is just slightly better than Led in types 1 and 4. And we already knew that type 3 has to use Dac.

So the evidence is in ...

Daclatasvir is the pan-genotypic choice.

And now AbbVie is getting high success rates WITHOUT Sofosbuvir !!!
www.prnewswire.com/news-releases/abbvies...irals-300252074.html

Let the price competition begin!
Last Edit: 3 years 1 month ago by klhilde.
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 3 days ago #16378

  • Meg
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Hi I am a bit confused about both what DAAs combination and length of tx are best for:
Genotype 1b
VL 1.200.000
Tx Naive
F0 - F1
ALT and other enzymes levels on the higher end of normal.

What is the criteria for either 8 weeks tx versus 12 weeks? Thank you.
Blood transfusion in 1992 - Diagnosed in 2007
Tx naive -G1b - F1
VL 2.270.000
ALT 40
Start tx June 4th/2016 with DAAs - Sof/Led from India
Bloods on two weeks of tx (June 18th)
AST 17 - ALT 10 - GGT 19
Virus UND
Bloods on six weeks of tx (July 16th)
AST 17 - ALT 8 - GGT 12
Virus UND
EOT on August 8th (did 9 weeks and 3 days)

SVR 4 Virus UND (September 7th)
AST 13 - ALT 5

SVR 14 Virus UND (November 12th)
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 3 days ago #16379

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Hi Meg,

With Harvoni and your profile - 1b, naive, low fibrosis, low viral load (<6 million) the evidence is that 8 weeks treatment is just as effective as 12.

You could do 12 for insurance/reassurance, but you fit the shorter treatment profile and using it would save you $500
YMMV
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Sof+Led vs Sof+Dac - and the winner is..... 3 years 3 days ago #16394

  • Meg
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Thank you!
Eight weeks tx feels like very good news! :)
Blood transfusion in 1992 - Diagnosed in 2007
Tx naive -G1b - F1
VL 2.270.000
ALT 40
Start tx June 4th/2016 with DAAs - Sof/Led from India
Bloods on two weeks of tx (June 18th)
AST 17 - ALT 10 - GGT 19
Virus UND
Bloods on six weeks of tx (July 16th)
AST 17 - ALT 8 - GGT 12
Virus UND
EOT on August 8th (did 9 weeks and 3 days)

SVR 4 Virus UND (September 7th)
AST 13 - ALT 5

SVR 14 Virus UND (November 12th)
Last Edit: 3 years 3 days ago by Meg.
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Sof+Led vs Sof+Dac - and the winner is..... 2 years 1 day ago #24504

  • Gert
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Treatment of GT1 in Denmark: Genotype 1 without cirrhosis

Hi James Freemann

For your information:

(1st choice to min. 70% of
Population) February 2017

Here is what the Danish health authorities recommend if they are offered treatment in Denmark

Viekirax® (ombitasvir 12.5 mg + paritaprevir
75 mg + ritonavir 50 mg) 2 tablets 1 x
Daily for 12 weeks
+
Exviera® (dasabuvir 250 mg) 2 x daily in 12
weeks
+
Ribavirin 2 x daily for 12 weeks


Before, there were 6 different treatment proposals, all of which were equal:

Genotype 1 without cirrhosis
Use as 1st choice for
mine. 70% off
population
(Genotype 1) Sep 2016:
(Strong recommendation for)
Sofosbuvir (400 mg) + ledipasvir (90 mg) 1 x daily
For 8-12 weeks *
or
Sofosbuvir 1 x daily (400 mg) and simprevir 1 x daily
(150 mg) for 12 weeks
or
Sofosbuvir 1 x daily (400 mg) and daclatasvir 1 x daily
(60 mg) for 12 weeks
or
Ombitasvir (12.5 mg) + paritaprevir (75 mg) + ritonavir
(50 mg) 2 tablets 1 x daily and dasabuvir (250 mg)
2 x daily for 12 weeks **
or
Sofosbuvir (400 mg) + velpatasvir (100 mg) 1 x daily
For 12 weeks
or
Elbasvir (50 mg) + grazoprevir (100 mg) 1 x daily for 12
week ***

Greeting
Gert
Probably infected 30 years ago Genotype: 1a
Fibroscan 4,8 - 18 january 2017
Virus in the blood 18 January 2017 10.400000 / Alat 102
Started treatment January 19, 2017
Feb.15 - Alat 76 - virus: UNDETECTED
March 15 - Alat 34 - virus UNDETECTED
April 12 - Alat 40 Asat 34 - virus UNDETECTED / Taking the last pill
May 10 SVR4 - Alat 36 -virus UNDETECTED
July 5 SVR12 - Fibroscan 3,8 Alat 39 - virus UNDETECTED
Sep. 27 SVR24 - ALAT 24- virus UNDETECTED
Marts 14 - 2018 SVR48 - ALAT 26- virus UNDETECTED
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Sof+Led vs Sof+Dac - and the winner is..... 2 years 1 day ago #24505

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Hi Meg,

With Harvoni and your profile - 1b, naive, low fibrosis, low viral load (<6 million) the evidence is that 8 weeks treatment is just as effective as 12.

You could do 12 for insurance/reassurance, but you fit the shorter treatment profile and using it would save you $500

Since writing this new evidence has come to light.

fixhepc.com/forum/experts-corner/1576-8-...2-weeks-harvoni.html

In short, 8 weeks is probably a bad choice unless you are very strapped financially, fit the profile and simply can't afford 12.
YMMV
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