Home Forums Main Forum Genotype Specific Genotype 1 (54%) Sof+Led vs Sof+Dac – and the winner is…..

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  • #9112
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    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

    #9136
    Avatar photodarbara
    • Guardian Angel
    • ★★★★★
    @darbara

    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

    #9151
    Avatar photoStew-H
    • Topics: 2
    • Replies: 28
    • Total: 30
    • Treatment Warrior
    • ★★★
    @stew-h

    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
    stewart.henstock@hotmail.com

    #15641
    Avatar phototweakmax
    • Guardian Angel
    • ★★★★★
    @tweakmax

    Do u have led vs dac data for redemption trial doc? Both equal in efficacy?

    #15650
    Avatar photoklhilde
    • Guardian Angel
    • ★★★★★
    @klhilde

    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 !!!
    http://www.prnewswire.com/news-releases/abbvies-investigational-pan-genotypic-regimen-of-abt-493-and-abt-530-shows-high-svr-rates-in-genotype-1-hepatitis-c-patients-who-failed-previous-therapy-with-direct-acting-antivirals-300252074.html

    Let the price competition begin!

    #17542
    Avatar photoMeg
    • Topics: 3
    • Replies: 92
    • Total: 95
    • Guardian Angel
    • ★★★★★
    @meg

    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)

    #17543
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    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

    #17559
    Avatar photoMeg
    • Topics: 3
    • Replies: 92
    • Total: 95
    • Guardian Angel
    • ★★★★★
    @meg

    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)

    #26114
    Avatar photoGert
    • Topics: 3
    • Replies: 55
    • Total: 58
    • Recovery Champion
    • ★★★★
    @gert

    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

    #26115
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    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.

    http://fixhepc.com/forum/experts-corner/1576-8-weeks-versus-12-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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