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Hep C Discussion Forum -> On Treatment -> For those taking Riba/sovaldi/interferon
Post Info TOPIC: For those taking Riba/sovaldi/interferon
jimbob


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RE: For those taking Riba/sovaldi/interferon
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That is great news Angie on your 4 week labs. I am very happy for you. I can certainly understand you wanting to be causious as I'm the same way. I am hoping to receive the same news next week. I had to argue with my gastro to get the VL test for week 4!

My PCP gave me Propranolol 10mg twice daily and Amitriptyline 25mg at nite for the headaches. It has heiped tremendously . You might talk to you doc to see if something like this works for you. It has also helped me to sleep.

After 4 weeks of the same meds as you, I'm experiencing some of the same effects. I'm having some fatigue, dizziness, anxiety and a little brain fog. But so far it has been very manageable. We'l just keep plugging Angie.

jimbob



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jimbob: 64 y/o, GT 1A, F1-F2, diagnosed 1996. Since 1970. SOT 3.5 mil VL on 3/10/14 with Sov/Rib/Peg for 12 weeks. Tx naive. UND @ week 4,8,12. EOT 6/2/14.
maddie


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Thanks, Tig.  Those graphs are very helpful.



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Dx. 2005-liver bx.: stg 2/gr 1. at that time  - GT 1a multiple transfusions in 1981.  Started Sovaldi and Olysio 1/16/14  (No prior treatments) Q80K present.  UND week 4,8 and at EOT.   UND at wk 4EOT, Und at wk 8EOT  SVR 12!!!..SVR 24 :-)
Tig


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Hi Gracie,

Here's some information on the subject of Sov/Led and the inclusion w/wo Riba. There is a bit of reading involved but you'll likely have a very good knowledge of the topic when completed. Pay particular attention to lengths of tx, existence or lack of the Q80K polymorphism, RAV's or lack thereof and tx naive and experienced participants. They all make a difference but often the omission of one component can be both significant or not. Everything has to be considered and this will bring you to the position myself and others faced shortly ago. That is of course, to treat or not to treat, that is the question... (pretty good huh?) Ledispavir is still pending FDA approval at this time.

Look at the image summary on the second link (about mid page). There are several graphics that will help your knowledge base greatly. This link also offers links to the various clinical trial study conclusions as well. Good luck!

Tig

The Hep C Blockbuster Season Begins

Once Daily Fixed Dose Sovaldi/Ledispavir in Clinical Trials

 



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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OldenSlow


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Gracie,

Your chance for SVR next time will likely be in the 99th percentile, assuming you wait until the newer stuff hits the market. If I remember right, you have minimal fibrosis? If that's the case you've got time. Sovaldi/Ledipasvir should be a butt kicker and should win approval stateside sometime in the fall. AbbVie and others have things coming along soon after that. It'll be months before there's enough followup data on S/O/R. Were I you, I'd skip the Olysio and wait for the good stuff.

wayne



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66 y/o male - Geno 1b - F4 cirrhotic dx 2001 - 16 wk treatment w/ Sovaldi/Olysio/Riba - Und @ EOT+24 SVR

 
Gracie


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Thanks Malcolm and Tig
So the combination of Sovaldi / Ledipasvir has the highest SVR for failed incevik/victrellis patients? And that's without RIBA?
What's the actual difference in SVR between Sovaldi / Ledipasvir and Sovaldi / Olysio / RIBA combo?
Are either available now or are they both off label still? Which one will become available first? Want to find my best chance of SVR this next time.
...I know... Questions questions.... :)


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  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
mallani


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Hi Gracie,

Tig has explained the RAV situation for failed Incivek/Victrelis patients. As Sovaldi is active against all of these known RAV's, it should not be a problem. However, to err on the safe side, Sovaldi/ Ledipasvir will take any uncertainty out of the equation. If I was Geno 1a, and had to take Sovaldi and Olysio, I'd want Riba as well . 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
Tig


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Gracie, 

Heres a brief snippet from an Olysio fact sheet (PDF) section 12.4 on the PI impact following relapse. If Sovaldi is utilized as the backbone drug in a combo or triple Rx, I believe the risk of Tx failure using a previous PI like Incivek/Victrelis is minimized. I'll add the full link at the bottom.

Tig

 

Cross-Resistance

Cross-resistance is expected among NS3/4A protease inhibitors. Some of the treatment-emergent NS3 amino acid substitutions detected in OLYSIO-treated subjects who did not achieve SVR in clinical trials, including R155K, which emerged frequently, and I170T, which emerged infrequently, have been shown to reduce the anti-HCV activity of the NS3/4A protease inhibitors, boceprevir and/or telaprevir.

The most frequently occurring boceprevir or telaprevir treatment-emergent NS3 amino acid substitutions that are expected to impact subsequent treatment with OLYSIO include R155K and A156T or V. The NS3 amino substitutions V36A or G and I170A or T, which displayed slight shifts in susceptibility to simeprevir in replicon cultures, may emerge in patients who do not achieve SVR with boceprevir or telaprevir, and may therefore also impact subsequent treatment with OLYSIO 

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/Olysio_pi.pdf



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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TazKat


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me too gracie.. those damn shots are the beasts.. but that is they are telling me..  :)



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TazKat Genotype 1A null responder x 3 riba & iterferon twice, relapsed from Incivek 2012 with only 12 weeks left to do. stage 4 mild cirrhosis 4/25/2014/ started sovaldi riba & interferon.. finished treatment 7/17/14  results 7/25  cleared..

 

 
Gracie


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You can't take Olysio because you took incevik? Really? I thought I read somewhere you could take the Sovaldi / Olysio combo with RIBA if you relapsed from incevik and that the SVR was still really high, like in the 90's. Darn if you can't as I'd love to avoid inteferon.



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  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
TazKat


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I will only be doing the sovaldi interferon & riba of low doage of 600 mg a day. i did the incivek & relapsed  the drug Olysio is in the pro tease inhibitor family.. can never do again.. there was an article on msn about the insurers were wary of pricey new drug!!  but they were saying it works & fast..



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TazKat Genotype 1A null responder x 3 riba & iterferon twice, relapsed from Incivek 2012 with only 12 weeks left to do. stage 4 mild cirrhosis 4/25/2014/ started sovaldi riba & interferon.. finished treatment 7/17/14  results 7/25  cleared..

 

 
Gracie


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I had a two to three day headache and did acupuncture with massage and it worked. Of course I was taking Tylenol extra strength as well. Congrats on 4 weeks UND. Loving the sounds of all these UND.... You guys rock and give me HOPE!



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  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
Cinnamon Girl


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Great news, Angie, congrats!!  You must be over the moon, this Sovaldi combo is certainly powerful stuff...believe it!!

I wouldn`t worry about your liver enzymes going up at this stage, as Tig said they often fluctuate quite a lot over the course of treatment, and the main thing is that the drugs are working and you`re Und!  Make sure you`re drinking enough water, it can help lessen the side effects.

Onwards and upwards!  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.

 

 
pl1952


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Good news Angie!  Congratulations!



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Me: 62 yr. old female, GT 1b, fibroscan 4.5; VL 650,975 as of 2/4/14;started Harvoni 3/6/15; SVR


Hubby: 59 yrs.; GT1b; fibroscan 25-cirrhotic; S/O for 12 weeks started tx 3/20/14; SVR56; fibroscan done 7-7-15 = 8.5
Tig


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Hi Angie,

Woot! Congratulations on your 4 week UND! I wouldn't worry about your enzymes at this stage. During the first weeks of Tx, I've seen them fluctuate considerably. As your liver begins it's return to normalcy, you'll see those levels begin their correction. Good luck!

Tig  



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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AngieV123


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Jimbob, glad to know you are doing better. These meds cause me headaches too. I'm prone to migraines and get them frequently. I can't find anything that helps. My only problems on these meds besides migraines are rash, fatigue, dizziness and heightened anxiety and other strange symptoms 24 to 48 hours after the shot. I wish everyone luck :)

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Type 1a. Had HCV my entire life via blood transfusion. Did peg & riba in 2000, relapsed. Did triple tx with sovaldi in early 2014 & I am now undetected 
AngieV123


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Thank you. .I am still trying to wrap my head around how fast these meds work!! Makes taking my shot tonight easier knowing that it's doing its job. Thank God for these new meds. Goodbye hcv..and stay out! Lol

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Type 1a. Had HCV my entire life via blood transfusion. Did peg & riba in 2000, relapsed. Did triple tx with sovaldi in early 2014 & I am now undetected 
Roxie


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Congratulations, Angie!  

 



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GT 1a / VL 6.5 million / age 64 / prior tx 1996 interferon

2/14/14 began Peg/Inf, Ribavin, Sovaldi for 12 weeks 

finished treatment 5/8/14  undetectable @ 4 wks, EOT & 12 wks
Matt Chris


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Hey Angie

Way to go! Congrats on your week 4 UND, it's a great day for you.

matt



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"And in the end, the love you take is equal to the love you make"

61 year old Geno type A1, F4 Cirrhotic, started 24 weeks on Harvoni 12-17-14 ,EOT-5 week = UND, 8-31-15 =UND , SVR-24 Baby YES! 
AngieV123


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I got back my 4 week labs and I am undetected!!! She did say that my liver enzymes were higher than pre tx though...is that normal? Most people on these meds see drops in alt and ast. My pre tx alt was 82 and ast 62. She didn't say exactly how high they were this time only that they are higher than that. I have to let this undetected thing sink in...As a former relapser I'm afraid to believe it!

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Type 1a. Had HCV my entire life via blood transfusion. Did peg & riba in 2000, relapsed. Did triple tx with sovaldi in early 2014 & I am now undetected 
jimbob


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Gracie--

Interferon, Riba and Sovaldi are generally prescribed for those with genotypes 1a, like myself.  If you are interferon intolerant,  youmay be able to to get another combo. The mods on here would know better than I.

I'm sorry you had to stop previous treatment, but Gracie, it may have been a blessing i. disguise with the new meds coming soon.

Wishing you much success.

jimbob 



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jimbob: 64 y/o, GT 1A, F1-F2, diagnosed 1996. Since 1970. SOT 3.5 mil VL on 3/10/14 with Sov/Rib/Peg for 12 weeks. Tx naive. UND @ week 4,8,12. EOT 6/2/14.
Roxie


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I did shot no. 7 last Friday night and am doing pretty well.  My fatigue is usually worse on Saturday/Sundays.  
 
Four week blood draw on 3/14 was virus undetectable.  My doctor said every patient he has on this combo comes back undetectable at four weeks. 
 
That same blood draw HGB was low so we reduced ribavirin to 800 mgs a day instead of 1200.  HGB stabilized pretty quickly, I feel better and doctor has now told me to come back in 6 weeks with repeat labs a week after my last shot. 
 
I'm sure you will get back an undetectable report.  This combo might not be as side effect free as some of the newer, but it's a miracle in my book!
 
One day at a time.   I'm raising my huge glass of water to a toast:   Success for all of us!
 
 
 


-- Edited by Roxie on Tuesday 1st of April 2014 03:31:29 AM

__________________

GT 1a / VL 6.5 million / age 64 / prior tx 1996 interferon

2/14/14 began Peg/Inf, Ribavin, Sovaldi for 12 weeks 

finished treatment 5/8/14  undetectable @ 4 wks, EOT & 12 wks
jimbob


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Hi Angie--

I've just started week 4. The first 10 days were surprisingly  good. The day after my first shot I felt the aches, but it was manageable. Haven't even felt the other shots. The 11th day the headaches hit - and I'm prone to headaches. The gastros didn't know what to do and told me to contact my PCP. He prescribe a beta-blocker and an AD. Both were older drugs and very affordable.  Because they're older, according to him, were less likely to give me a headache. It worked. I suffered for about 4 days until I saw him. Also, the BB and AD has helped me to sleep. Since then, it has gone rather smoothly. Of course, it's only been 4 weeks, and I'm the type that is always waiting for the other shoe to drop. That said, overall to date, it has gone better than expected. Just hope the remainder goes as well. :)

jimbob

 



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jimbob: 64 y/o, GT 1A, F1-F2, diagnosed 1996. Since 1970. SOT 3.5 mil VL on 3/10/14 with Sov/Rib/Peg for 12 weeks. Tx naive. UND @ week 4,8,12. EOT 6/2/14.
Gracie


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Taz... Is there a reason you are doing this combo and not the Sovaldi / Olysio / RIBA combo? Is the results on this combo the same? Or is that what your doctor recommended? There seems to be the inteferon and without inteferon groups. I'm wondering what the differences are in regards to SVR. Inteferon wreaked havoc on my ANC counts.



-- Edited by Gracie on Tuesday 1st of April 2014 02:39:26 AM

__________________
  1. Gracie

1A. Previously treated non responder Rebetron in 2000 And Incevik in 2014 with a breakthrough at week 12. Fibroscan 15.5. VL 6,000,000. Finished 24 weeks harvoni on Dec. 19, 2015. SVR. Latest Fibroscan 8.8.
TazKat


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wow, tried to reply twice. hoping to start this very thing in a month or so.. so good luck to us!!!!!!



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TazKat Genotype 1A null responder x 3 riba & iterferon twice, relapsed from Incivek 2012 with only 12 weeks left to do. stage 4 mild cirrhosis 4/25/2014/ started sovaldi riba & interferon.. finished treatment 7/17/14  results 7/25  cleared..

 

 
AngieV123


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Hello. I am going on week 5 and wondering where everyone else is at on their tx and how everyone is doing? 



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Type 1a. Had HCV my entire life via blood transfusion. Did peg & riba in 2000, relapsed. Did triple tx with sovaldi in early 2014 & I am now undetected 
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