Replies to post #71788 on Biotech Values

[DewDiligence]

Re: IFN use in HCV

I'd be willing to bet that in 10-15 years or so, when we have the first long term follow up data on SVRs for antiviral without ifn cocktails that the relapse rate is much higher than with regimens including ifn. Instead of <<1%/year it is over 3%yr (WAG).

This is subsumed within Boger’s statement I referred to in the previous message. I.e., the 85% number that Boger cited is the true cure rate and the reported SVR rate may have to be modestly higher than this to allow for “late” relapses.

All this is a “second order” issue insofar as we’re talking about the difference between 85% and, say, 88%. Whether Boger’s Threshold is 85% or 88% does not fundamentally alter Boger’s thesis that the Law of Diminishing Returns will make it economically unattractive for companies to seek even higher SVR rates.

[dewophile]

HCV and interferon

"Dew believes that antivirals will knock it down low enough that it the immune system can bring it under control. Maybe. I believe that there is a good chance that in order to get a cure the immune system has to be trained to find it and that anti-virals alone won't do that as well as when combined with interferon"

it is possible that ribavirin alone will be enough to "train" the immune system. the argument against this is ribavirin has only shown meaningful efficacy in conjunction with interferon. no one knows how it will behave in conjunction with direct antivirals in the absence of interferon


"I'd be willing to bet that in 10-15 years or so, when we have the first long term follow up data on SVRs for antiviral wo ifn cocktails that the relapse rate is much higher than with regimens including ifn. Instead of <<1%/year it is over 3%yr (WAG). "

whether or not an SVR is as meaningful a predictor of long-term suppression without interferon will definitely need to be studied when non-inf regimens are studied. from a clinical and regulatory perspective though SVR is likely to remain the gold standard for efficacy and approval

PS: it's a real shame gofishmarko doesn't post any longer - he/she was always very knowledgable in the hep arena

PPS: one recommendation to improve the board is to have a sticky thread inviting former respected posters back to the board (rfj, gofish, etc...perhaps even unban io if he promises to behave;)