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Hep C Discussion Forum -> General Discussion -> Incivek v Victrelis- final thoughts
Post Info TOPIC: Incivek v Victrelis- final thoughts
mallani


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RE: Incivek v Victrelis- final thoughts
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Incivek has outsold Victrelis 3:1 in the USA. I doubt this will happen in other countries.

I think it's initial popularity was based on some pretty biased trials. The simpler pill regime and shorter standard Rx duration ( by 4 weeks) also played a part. Once Hepatologists start using one drug they get used to it and need a good reason to change.

I have mentioned that Incivek has been poorly tolerated here in Queensland - possibly due to climate. Vertex were very reluctant to make it available in Australia, which didn't go down well. There is an ongoing study which indicates Victrelis has slighty better SVR rates for cirrhotics. When some results get published, I'll make it available.

If patients are able to make an informed decision, I'm in favour of them being given a choice.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
Bills


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Very interesting Malcom. Thats a very sensable easy to understand compairson.  Alot of the results of these trails being posted are very confusing to me in the technical terms the scientist use % of all the classes.  By the way hope you get off to a fast recovery from the TX. Im very glad to see you finish. You almost made look easy. good Luck 

Bills 



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Bills

Harvoni started 12-12-14 for 24 wks PrevTX Geno 1 stage 3 cirrhosis - non resp Int/ ribv. Started Trial  in Aug 2011 -July 2012 into Incivek relapsed  Feb 2013 Had 72 weeks on interferon & Riba.

Phil G


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I had just turned 57 at the start of tx and worked full time through it. I'll take my 4 + 24 weeks on Victrelis and the anemia over Incivik anyday. My guess would be that well over half of the threads on this forum are dealing with the particular sx and requirements of Incivik.



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Geno 1A, VL 1.9 mm, SOT 12/2/11 - Pegintron/Ribavirin/Victrelis, UND since wk 8, EOT 6/15/12 (28 wks), SVR 11/30/12
jrc


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Nice info Malcom, for me vic was great.Im 32 years old and responded to the 4 week lead amazingly ,and in the begining i questioned my dr about me going on vic but after seeing what the sx of inciv were im glad i was on the vic !



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Geno 1 A Started Tx w/ Victrelis  8-3-11, Viral Load  21.2 Million,  Und Weeks 4 Through 28 ,End Of Tx 2-15-2012 !SVR
Biggyb


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Thanks for the input, but i think it should be maybe 55 and up.



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58 yo..Relapsed in 99 and again in 2004. Started triple therapy with Victrelis July 22,2012.  genotype 1a. week 8,12,16,24 VL Undetectable..E.O.T -- 6-22-2013,,,EOT + 24., UND. 

SVR !!!

 

~Bob~
mallani


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Hi all,

The old antiproteases will disappear from the US Pharmacies in a few years. However many countries still do not have access to Inciv and Vict. as yet ( except for the rich). For Canada, Europe and UK and Australasia, these drugs will be be the frontline drugs for HCV for another 6-8 years.

The essential differences between the 2 drugs has been discussed. Incivek is more potent initially but has Sx that include a nasty rash and anorectal issues, and it needs to be ingested with fat. It is so toxic that it can only be used for 12 weeks. Victrelis needs a leadin to lower the VL, and has a slow but increasing action. By 18 weeks, the Undet. rates for both drugs are the same. Victrelis is more likely to cause anaemia and dysgeusia. Victrelis is well tolerated by the gut and can be taken for at least 44 weeks. The pill burden is high and not well received by patients.

Who should take what? I think this depends on the liver fibrosis score. For F0 to F2, Incivek is the drug of choice. Provided VL targets are met and Rx doesn't stop due to Sx, this should be a 24 week Rx regime. For F3 and F4 ( and patients over 60 yo) Victrelis is the drug I'd choose. With increasing liver fibrosis and decreased perfusion, you need a long steady exposure to the active drugs. With Incivek you get the initial blast, then just Peg and Riba.  F3's and F4's need 36-48 weeks treatment. Victrelis allows all 3 drugs to be used for the whole Rx period. For F4's there will be significant anaemia. How this is managed will depend on your Hepatologist and which country you're in.

Non-US Hepatologists are now getting experienced in this. Hopefully some up-to-date guidelines will be published.



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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
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