Biotech Values

[iwfal]

HCV and DAA-only regimens

The speed at which this two drug combination knocks down the virus to near undetectable levels could mark the end of interferon. The virus doesn't have the time to build resistance or mutate.

Based upon the BMY data for the 2 DAA regimen it appears that RVR is not as good a predictor of SVR in a DAA-only regimen as it is in SOC. >40% of RVRs either broke through or relapsed after end of treatment. I.e. "Speed of response" means less in DAA-only regiments than it does in SOC.


Question 1: What do you think the SVR rate for the same BMY DAA-only regimen looks like in naives? (I think there is a general assumption being made that if the DAA-only regimen is getting 36% SVR in nulls then it will get >>90% in naives - and I don't think that is necessarily true. Extremely hardy virus wrt SOC doesn't entirely equate to extremely hardy virus wrt DAAs.)

I'm more comfortable saying Riba is done with, considering it's just a weak nucleoside which works very well with interferon, and the testing we are currently seeing in combo with Riba is just a slow shedding of SOC.

Question 2: If you were a patient and were offered a 24 week course with 90+% chance of SVR in 24 weeks of a 3 DAA only treatment or 90% chance of SVR in 12 weeks of a 3 DAA plus SOC which would you choose? Keeping in mind that the DAAs are not benign in their AE. And keeping in mind that clearly BMY is targeting to use an interferon which has much lower AE then inf-a.