"the median baseline viral load in these two cohorts was in the range 2 million international units of HCV/RNA per ml of plasma or 2 times 6 logs. And the level of undetectability for the assay was 20 international units per ml, a median 5 log drop is the maximum effect that could have been delivered by any therapy before reaching the level of viral undetectability or the level below which the assay cannot detect additional log drops. In other words, the direct antiviral agent combination of 191 and 7128 in the INFORM study maximized the median viral load reduction that was possible in these two cohorts, more log drop was not possible. "
agree that baseline viral loads is important in the context of evaluating potency of the drug combination. and the results are impressive. however - and i did not listen to the call so perhaps i am taking this out of context - the implication that the results are as good as can be is incorrect. "more [median] log drop was not possible" may be true, but clearly median log drop doesn't tell the whole story as there were patients who were not cleared of virus. in fact one patient in the highest dose cohort had a 2.7 log drop, so i suspect the mean log drop would not have been anywhere close to the theoretical maximal log drop possible. looking at the individual curves one of the patients with a lower baseline viral load - an indicator of better prognosis - did not clear virus - so there do not seem to be uniformly superb responses
that said i really don't want to diminish the results - i think the fact most were not undetectable is NOT a bad thing considering the sensitivity of the assays used - and the 70% below the level of quantification is actually the better metric as once you're <40 you're essentially on your way to EVR (and some >40 will get to EVR.
perhaps i am out of line because i don't listen to itmn's calls much (i think i will start to) but on first blush from reading these comments i get the feeling welch can be a tad disingenuous
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