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Hep C Discussion Forum -> Knowledge/Info Section -> Information on HCV trials involving people with co-morbid mental heath issues
Post Info TOPIC: Information on HCV trials involving people with co-morbid mental heath issues
TM4N


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Information on HCV trials involving people with co-morbid mental heath issues
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Hi Malcom, yeah thanks for that bit of information mate. That's handy to know.  



-- Edited by TM4N on Tuesday 11th of March 2014 11:45:51 PM

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Tehimana
mallani


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Hi Tehimana,

Victrelis (Boceprevir) is available in the Land of the Long White Cloud. Here is a link.

http://www.pharmac.health.nz/assets/notification-2013-08-09-boceprevir-and-pegylated-interferon.pdf

As you can see, there are some strings attached, but it's not much different in Australia. You need to get your IL28B Genotype done and hope you're not the CC allele.

I've now had 4 courses of Interferon, and although it's no picnic, it's doable and worth it to get rid of the virus. Sovaldi and the new DAA's, will take 3-5 years to become available in Oz and NZ, so treatment decisions are based on the amount of liver damage. Cheers.

 



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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
TM4N


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Hi Jill, that was great little article my friend. Very interesting how these new inhibitor medications have next to nothing in the way of serious side effects. As well I'm quite buoyed by how these newer medications have significantly higher rates of success in eradicating HCV illnesses. I was also able to link into other associated articles about that very same study, and articles on other similar studies, to observe much lower rates of relapse or failure were found to occure among recipeints than previously recorded. I live in a small town in a remote part of Aotearoa New Zealand. I have been introduced to at least two people I can confirm who have found the Interferon/Ribavirin ****tail side effects too much of a challenge to contend with during their treatment phases. In both cases the illnesse regained ascendency in their lives. And once again in both cases, apathy was very evident in their demeanour and view on life in general. 

So yeah, good on the American and European pharmaceutical companies for taking this pandemic by the horns. I honestly believe it's the only real chance the world has to get on top of this pandemeic.  



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Tehimana
Cinnamon Girl


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You`re welcome, Tehimana, and I`m sorry I couldn`t provide you with more information.  The article I gave a link to really only deals with issues of compliance and SVR outcomes from that particular trial, and not how the participants with mental health issues actually coped with it day by day or what type of support they needed, if any. 

The side effects from conventional treatment can be very challenging, although it does vary quite a lot from person to person.  Of course having an existing psychiatric condition is something your friend needs to take into account, as treatment drugs like ribavirin and interferon can cause depression, anxiety, and changes in behaviour in some people. 

As long as your friend is in relatively good health and has little or no liver damage then he has time to wait for better and much easier treatment options to become available.  All the new treatment drugs and combos are showing very high success rates, and if you follow the posts in our `HCV News` and `On Treatment` sections you`ll find plenty of information on the current situation regarding new drugs available now or in the pipeline.

If I come across any more information that could be useful to you and your friend I`ll let you know. 

Wishing you all the best. ~ Jill



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Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
TM4N


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Wow you are so kind. Thank you very much the link friend. The key information I hope to get from these sorts of studies, is how to help/support someone who is facing the onslaught of powerful side effects brought about by different treatment regimes. And the general consensus from reading many of your posts is that, undergoing HCV treatment in any form is mostly horrendous. I just hope my friend is provided a treatment approach with somewhat less harrowing experiences.

Having some experience in Social Science Research, and mostly in qualitative research, I'm hoping to see if I can read a bit between the lines as to how poor mental health sufferers have handled the extra burden of the side effects. What's more, what they found to be most difficult about HCV drug therapies presently used. I'm also keenly interested in the clinical trial information to see which new forms of HCV appear most promising. In New Zealand, the land of dark ages by all accounts, and from reading how many treatment combinations appear available to sufferers in the U.S. and other countries; HCV is still largely treated using a Ribavirin/Interferon combination. 

Man...are we behind the times. But thanks again for the link.hmmconfusesmile      



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Tehimana
Cinnamon Girl


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Hi Tehimana, welcome to the forum!  Yes, it would be much better for your friend to wait for interferon-free treatments to become available in New Zealand, and that way he would avoid a lot of the worst and most stressful side effects. 

There was a small clinical trial last year which was designed for people with genotype 1 and which included a sample of patients with `unfavourable treatment characteristics`, including mental health issues.  The drugs used in the study were sofosbuvir (Sovaldi) and ribavirin, for 24 weeks.  Here`s a link to the details, and a quote from the article...

 "In the SPARE study, Nelson and colleagues treated 60 HCV patients, all with genotype 1 disease, for 24 weeks with daily sofosbuvir (at 400 mg) and either low-dose or weight-based ribavirin.  Of those, 23 had an active mental health disorder, defined as requiring pharmacotherapy for major depression, bipolar disorder, schizophrenia, anxiety, or depression with anxiety."

http://www.medpagetoday.com/MeetingCoverage/AASLD/42719

There will also be other drug treatments coming along without interferon or ribavirin which might be more suitable, although I don`t have a timeline for when they will be available outside the U.S.

Hope that helps!  smile



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Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
TM4N


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Hi there guys, I think i'm in the right place. Just reading some of the posts, I feel honoured to be among some very informed people; which is where I need to be right now. I'm from Aotearoa "The land of the long white cloud" or New Zealand as it is known by it's other name. It's a place where people appear to be treated mostly based on punitive worth.  I support a friend who has HCV genome type 1, and I'm not sure whether it's type 1b or 1a either. But my friend also suffers from a successfully controlled mental health type illness. He awaits treatment for his HCV illness but is not eligible for an interferon based treatment for fear of it affecting his preexisting condition.

Can someone point me to information where people with preexisting comorbid mental health issues have undergone clinical trials involving HCV drug therapy?I've done google searches on this topic but haven't turned up much about it. I would dearly love to know the findings of such trials. smileno



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Tehimana
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