HealingWell
Search Close Search
☰

Biopsy results, and 3-drug combo question

Support Forums
>
Hepatitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/23/2010 3:24 PM (GMT 0)
My doctor called yesterday with my results and said I have minor scarring and minor swelling and it is in stage 1, therefore she recommends the treatment.

1) What is in stage 1?

2) When is that 3-drug combo coming out? My doctor said they have been saying it is coming for years so she can't say for sure. Does anyone have details?


EDIT: what are the three drugs in this combo?


thanks

Post Edited (dissectx) : 10/23/2010 10:36:30 AM (GMT-6)

Posted 10/23/2010 5:29 PM (GMT 0)
I have just been diagnosed also and had biopsy done 2 weeks ago. I am also stage 1 and would like to know when new treatments will be available. 48 weeks of tx does not sound very appealing to me. i have absolutely no symptoms at all and leading a very normal life. This is all very confusing for me.
Posted 10/23/2010 6:22 PM (GMT 0)

OMGhepc, welcome to the forum.  I like your screen name...kind of says it all, doesn't it?

Dissectx and OMG, stage 1 means no cirrhosis, liver cancer, or decompensated liver disease.  Your livers are just beginning to show signs of hep C damage.

When I last saw my hepatologist in June, she said the new 3-drug treatment should be available the first half of 2011.  There are a number of companies that have come up with some form of this treatment, but the ones nearing FDA approval are Vertex's. which includes roceprevir as the 3rd drug, and Merck's telaprevir.  The other two drugs are the same as in the present combo, some form of interferon and ribavirin.  In June, she was telling me that the new treatment only needed to be taken for 24 weeks.  Then I started hearing 48 weeks.  I saw the hep doc's ARNP in Sept. for an unrelated problem.  She said if a patient is responding, they want them to do 48 weeks to lessen the chance of relapse.  This month, I spoke with a research doctor in hepatology at Mayo.  He also seemed to agree that treatment would be 48 weeks for those who are early responders.  If one is not showing clearance by 12 weeks (or sooner), they are taken off treatment.  I believe that early on they thought that due to the 75% clearance rate, it would only take 24 weeks of treatment.  However, when more time passed and they were able to assess relapse rates, they concluded that to be on the safe side 48 weeks would be needed if a patient is responding, to minimize relapse.

This recent news does not make me happy, as I had planned to take the treatment when I heard it would only be for 24 weeks.  Now I just don't know.  I will know more about when it will be available and what the protocol will be when I see my hepatologist in Dec.  But you may want to ask some hard questions of your doctors.  The availability may also be at a later date than originally thought.

Hugs,

Connie


Posted 10/23/2010 9:34 PM (GMT 0)

You have minimal damage at this point, so if you want to wait a few years for newer treatments you should be able to.  The length of treatment would depend on your response to treatment and amount of liver damage.  I do not think anyone with significant liver damage would  treat for 24 weeks with the new treatments.  I have posted below a bit of info on how liver damage is scored.

The Metavir scoring system was specially designed for patients with hepatitis C. The scoring consists of using a grading and a staging system. The grade gives an indication of the activity or amount of inflammation and the stage represents the amount of fibrosis or scarring. The grade is assigned a number based on the degree of inflammation, which is usually scored from 0-4 with 0 being no activity and 3 or 4 considered severe activity. The amount of inflammation is important because it is considered a precursor to fibrosis.

The fibrosis score is also assigned a number from 0-4:

• 0 = no scarring

• 1 = minimal scarring

• 2 = scarring has occurred and extends outside

the areas in the liver that contains blood vessels

• 3=bridging fibrosis is spreading and

connecting to other areas that contain fibrosis

• 4=cirrhosis or advanced scarring of the liver

Posted 10/24/2010 2:28 AM (GMT 0)

hep93 said...
OMGhepc, welcome to the forum. I like your screen name...kind of says it all, doesn't it?

Connie


I found this webpage for Vertex's current clinical studies: http://www.vrtx.com/current-projects/Clinical-Trials.html


and I think this is their actual recruitment page: http://www.clinicaltrials.gov/ct2/show/NCT01080222?term=hepatitis+c+phase+2&recr=open&lead=vertex&rank=2

THANKS EVERYONE FOR YOUR RESPONSES turn
Posted 10/24/2010 1:37 PM (GMT 0)
Thank you everyone for your responses. I am genotype 1A and have probably had this since I was a child as I had a gammaglobulin shot back then . I am so confused and angry.

My doctor wants me to start treatment. I am very skeptical about this. Do I want to do this for almost a year with not such good odds of being cured? It is such a huge decision.
Posted 10/24/2010 6:09 PM (GMT 0)

OMGhepc, I just want to caution against using the word "cure," as there isn't any.  If treatment works for you, they will say the hep C is "undetectable" or that you've had clearance of the virus.  A "cure" means it will never come back.  There's a chance that hep C will return...kind of like a cancer diagnosis.

Without treatment, though, you have to be aware that it will probably progress to cirrhosis and possibly liver failure.  You will also be at higher risk for liver cancer without treatment.  That's what happened to me and is all too common.

It IS a big decision.  Talk to your doctor about it, ask questions, and research it.

Hugs,

Connie

Posted 10/25/2010 10:03 PM (GMT 0)

SVR is the closest you'll get to "a cure" for hepatitis. Sustained virologic response, or SVR, is the goal of hep C treatment. SOC (a combination of interferon and ribavirin) doesn't necessarily eliminate the hepatitis C virus from your liver. It can, however, suppress the virus to undetectable levels for an extended period of time. In clinical language, this is called a "sustained virologic response," or sustained response. It means that during the six months after you complete treatment, there is no detectable hepatitis C virus in your blood.

SVR is a good thing. Studies have shown that with a six-month SVR (which means no detectable virus in your blood for six months after finishing treatment), relapse occurred in only 1-2% of patients. So, for every 100 people who finished treatment and attained SVR, the virus will return in only 2 of them. However, for these people, the virus never really left. The medicine was able to eliminate most of the virus (so much that medical tests couldn't detect it), but after treatment ended, for whatever reason the virus was able to continue replicating itself.  The virus canalso return when people reinfect themselves (ie return to iv drug use)

I disagree though that the natural progression for everyone with hep c is cirrhosis & possible liver faiure. Only 20% of people diagnosed will go on to get cirrhosis, the rest will have varying amounts of liver damage, unfortunalty it is impossible to predict who will progress to cirrhosis so it is best that everyone who has a diagnosis of Hep C undergo treatment to eliminate the virus.

Lots of things should come into play when deciding to treat.

Do you work? - work & treatment can be very hard!

Are you at a healthy weight? - A healthy BMI is optimal for treatment

Have you been tested for Insulin Resistance? - IR has been shown to lower chances of achieving SVR.

Age? - younger age has better odds of clearing the virus

It is a very personal decision deciding to treat and no one can tell you either way which is better (wait for new treatments or jump in now).  What I would do though is learn as much as you can about the virus so that you can advocate for yourself when meeting with treatment professionals.

✚ New Topic ✚ Reply