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Author Topic: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?  (Read 13848 times)

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Offline sconan

  • Newbie
  • Posts: 1
Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« on: April 23, 2015, 05:27:01 pm »
Hi All,

I'm seeking some opinions. I was treated for Hep C 1a about 3 years ago using Interferon and Ribavirin for 72 weeks. After 4 weeks, I wasn't showing much change and it took another 4 weeks to really start going in the right direction. At end of treatment I was undetectable, but relapsed at EOT + 12 week mark. I didn't really have any major side effects aside from fatigue and some irritability.

I am slated to start treatment with Harvoni in approximately six months (Oct 2015), since it's taking a while to work through the backlog at Kaiser. However, I recently got a call from Kaiser about doing a clinical trial using Viekira Pak + Ribavirin starting in a few weeks. Both treatments would run 12 weeks.

From what I can see, it looks like Viekira Pak + Ribavirin has a 1-2.5% advantage in other trials for relapsed patients with no cirrhosis. (See Sapphire I, Sapphire II, Pearl II) vs Harvoni.

Since I think I can tolerate the ribavirin side effects and can start earlier, coupled with the slight increase in SVR, I'm leaning towards doing the trial. I'd love to hear some other opinions.

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Offline Philadelphia

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  • Posts: 1,157
  • It only looks like I know what I'm doing
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #1 on: April 23, 2015, 06:58:33 pm »
The figures coming out of the forums here seem to show little difference in outcomes between the two, although it must be said there are more Harvonians than Viekirians. You've obviously already gone through the trials data.  I'm taking Viekira Pak + riba and it's quite doable. My ALT and AST have dropped from 137 and 185 respectively to 30 and 36 in 4 weeks. My VL dropped from 340,000 to 45 in two weeks.

I guess my question would be does taking either drug preclude you from the other one down the track if the treatment doesn't work. If the answer is NO, I'd say go for it.
Logged
CURED SVR24  Class of 2015
Wk 12 post EOT 30.11.15: ALT 14 AST 22 GGT 22 VL UND
Week 19 07.08.15: ALT 17 AST 23 GGT 25
Week 12 18.06.15: ALT 21 AST 23 GGT 28
Week 8 25.05.15: ALT 23 AST 27 GGT 30 VL UND
Week 4 20.04.14: ALT 30 AST 36 VL 40
Treatment start 23.03.15: ALT 137 AST 185 VL 342,600
Cirrhosis Child-Pugh A, Genotype 1a - Viekira Pak + riba 24 weeks
Total failure interferon/ribavirin/boceprovir Mar 2013
https://www.hepmag.com/blogger/grace-campbell

Offline sapphire101

  • Member
  • Posts: 238
  • "Stop worrying and start living"
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #2 on: April 28, 2015, 12:40:54 am »
Warning: high potential for a dumb question (yes there are).

Why are you being offered viekira pak with ribavirin as a clinical trial Sconan when this medication regimen is already approved by the FDA?
Can it still be considered a clinical trial if it is already out there being prescribed?
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Sapphire101
Genotype 1a Fibrosis level 1
Viekira Pak with ribavirin 12 weeks
Pre treatment  VL  1.7 million, AST 45 ALT 65
EOT VL not detected, AST 21 ALT 21
12 week SVR not detected,24 week SVR not detected.
Cured! Class of 2015

Offline Lynn K

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  • Get tested, get treated, get cured, fight Hep c!
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #3 on: April 28, 2015, 05:13:01 am »
Hi Sapphire

They still do clinical trials involving approved meds maybe adding an additional med maybe changing treatment lengths of different groups of patients

I just found 6 for Harvoni that are recruiting

https://clinicaltrials.gov/ct2/results?term=Harvoni&recr=Open


And this one for Viekira Pak

https://clinicaltrials.gov/ct2/results?term=Ombitasvir+paritaprevir+ritonavir&Search=Search
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline sapphire101

  • Member
  • Posts: 238
  • "Stop worrying and start living"
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #4 on: April 28, 2015, 10:54:27 am »
Lynn K this is important information and I was totally uninformed about the clinical trial options.


 Could you repost under "if you can't get approval". So many people on this forum are stuck in limbo or facing really tough decisions around treatment. I would have jumped on this if my insurance had not come thru.
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Sapphire101
Genotype 1a Fibrosis level 1
Viekira Pak with ribavirin 12 weeks
Pre treatment  VL  1.7 million, AST 45 ALT 65
EOT VL not detected, AST 21 ALT 21
12 week SVR not detected,24 week SVR not detected.
Cured! Class of 2015

Offline Debula

  • Member
  • Posts: 257
  • "Your body hears everything your mind says"
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #5 on: April 28, 2015, 01:38:59 pm »
Quote
Could you repost under "if you can't get approval". So many people on this forum are stuck in limbo or facing really tough decisions around treatment. I would have jumped on this if my insurance had not come thru
.

Same here!  I had no idea they were still doing clinical trials
My husband may have a problem with our insurance since I don't think his liver is as bad as mine (we will find out Friday) so a clinical trial might be an option for him.  Or my support path
Logged
80's DX: NonA,B
Non responder to Interferon
3/6/2015-GT 1a
VL-1920000 IU/mL
FibroSURE: Fibrosis stage F4 (0.79)
                  Necroinflammat activity A3 Severe (0.75)
AST 88,  ALT 120, Platelets 73
4/16/2015-Started Harvoni (24 weeks)
5/13/2015-4 weeks AST 26, ALT 36 
5/22/2015-5 weeks  VL UND
6/17/2015-9 weeks  VL UND AST 28 ALT 40
7/31/2015-15 weeks VL UND AST 27 ALT 39
9/22 Diagnosed with HCC
10/1-EOT
10/29-SVR4
12/23-SVR12
I AM HEPC FREE! :)

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,546
  • Get tested, get treated, get cured, fight Hep c!
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #6 on: April 28, 2015, 03:25:31 pm »
https://clinicaltrials.gov

Usually it helps if your doctor is involved with clinical trials another good reason to be followed by a doctor associated with a liver transplant center as they are where trials are being done.

Ask your doctor about clinical trials in your area that you may qualify to participate in.

I was involved with 2 trials my doctor asked me if I would be interested in participating and as I had no treatment options available to me at that time that I had not already tried and failed I said "sign me up"
« Last Edit: April 28, 2015, 03:27:26 pm by Lynn K »
Logged
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Philadelphia

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  • Member
  • Posts: 1,157
  • It only looks like I know what I'm doing
Re: Harvoni vs Viekira Pak + Ribavirin - Which would you choose?
« Reply #7 on: April 29, 2015, 05:20:26 pm »
I changed specialists from my regional guy to the head of the viral hepatitis clinical research program in Sydney for that very reason Lynn. People here couldn't understand why I was doing it, including my GP. I knew exactly why. Best care possible, no cost, public hospital.
Logged
CURED SVR24  Class of 2015
Wk 12 post EOT 30.11.15: ALT 14 AST 22 GGT 22 VL UND
Week 19 07.08.15: ALT 17 AST 23 GGT 25
Week 12 18.06.15: ALT 21 AST 23 GGT 28
Week 8 25.05.15: ALT 23 AST 27 GGT 30 VL UND
Week 4 20.04.14: ALT 30 AST 36 VL 40
Treatment start 23.03.15: ALT 137 AST 185 VL 342,600
Cirrhosis Child-Pugh A, Genotype 1a - Viekira Pak + riba 24 weeks
Total failure interferon/ribavirin/boceprovir Mar 2013
https://www.hepmag.com/blogger/grace-campbell
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