Telaprevir SVR Rates Unaffected by Ribavirin Dose Reduction

[flcyclist]

For those struggling with anemia, following is some recent information regarding Riba dose reduction with Telaprevir.  Sorry if it was already posted.  

The data shows that similar sustained virologic response (SVR) rates were achieved regardless of ribavirin dose reduction, including dose reduction to ≤ 600mg/day in a telaprevir-based treatment regimen for both treatment naïve and previously treated genotype-1 chronic HCV patients.[1]

http://www.prnewswire.com/news-releases/incivo-telaprevir-svr-rates-unaffected-by-ribavirin-dose-reduction-in-treatment-naive-and-previously-treated-patients-with-genotype-1-chronic-hcv-147925655.html

[copyman]

Agree with the study. I lived it first hand.
I had my riba dose reduced because of anemia during a Telap study back in 2009. Around the 13th week Riba was reduced from 1200mg to 600mg for about a month. Still SVR'd.

[willbb]

cando .agreed  there doesn't seem to be enough data yet on chirrotic's(with P.I therapy),however given the last sentence below it would seem reduction possibly keeps some chirrotic's in the game
Best..
Will

Summary of Key Conclusions
In real-world setting, poor safety profiles for telaprevir- and boceprevir-based regimens in patients with genotype 1 HCV and compensated cirrhosis who had relapse or partial response to previous peginterferon (pegIFN)/ribavirin (RBV) therapy
Rates of serious adverse events markedly higher (38% to 49%) than in phase III trial results (9% to 14%)[2-6]
High rates of discontinuation because of adverse events (7% to 15%)
Grade 3/4 anemia common with both regimens and responded poorly to erythropoietin

http://www.clinicaloptions.com/Hepatitis/Conference%20Coverage/Barcelona%202012/Tracks/Highlights%20From%20Barcelona/Capsules/8.aspx

[willbb]

Keith ..As per dosing protocols (both within your trial and also if you were treating clinically)   they are doing dosing correctly . As I mentioned..35 weeks in and with approx. 30 of that UND you should be just fine ..
Hang tough ..
Will.

[hrsepwrguy]

Right at the moment I am on a wait and see basis, I go for labs tomorrow (5 days reduced) and if I have shown a decrease, I will stayed reduced and procrit will be ordered, if I have stablized or show an increase I will be managed by dose reduction on an as needed basis, I really have no say in the decisions, but it was my decision to join the trial and I have to follow thier protocol, the kicker is that if I fall below 8 I will be removed from the trial which I would rather continue than to dose myself and end up being removed.

[frijole]

Good to see you.  You hit it on the head -- we want the edge and every nuance is important.  I also think 100% compliance is important -- none of this 80/80 cr@p.  100%.  

[Trish77]

"Yes this is true, but only once one is Und. Trials showing a lower dose of riba starting out did not work out to well."

As well as lower dose starting out, data showed that reductions in the first 12 weeks on PI's showed low-er rates of SVR than if riba reductions came later on.  For people looking to grab every percentage of advantage towards a cure, the nuances to this are important.  If it were me on treatment again with one of these two PI's, I'd be looking to maintain dosage for the first while as much as possible, without risking health.