Replies to post #97566 on Biotech Values

[dewophile]

re HCV DAA combo trials

there’s only so much information one can convey in a compact table

yes, but i don't feel that column - the way it is currently formatted - adds any valuable information as to the performance of non-riba containing regimens, which i presume is the reason the column is included in the first place (for the reason cited in my original post). if you want to include a column for arms w/w/o riba my suggestion would be to include only those arms that NEVER use riba - jmo

It may turn out that ribavirin is not uniquely relevant in preventing HCV relapse, but rather is just a weak DAA that mops up mutations to a drug like Telaprevir and can be replaced with a newer and better second-DAA agent

i think the evidence to date, albeit limited, is pretty clear that riba is more than just a weak DAA whose main function is inhibition of resistance to another agent. e.g. inf - a moderately potent antiviral - combined with riba did better at achieving svr than a more potent antiviral in telaprevir (or nm-283 although the difference in SVR in that trial was small). also the on treatment response is better for the more potent agents conbined with inf despite worse SVR - again suggesting some relapse-specific MOA. that said, whether or not 2 very potent antivirals would achieve different outocmes than a very potent plus inf 9medium potency) is an open question, but i am on the record on this board that i have my doubts (and frankly i think IF riba can be dropped it will be for a small subset - perhaps vrtx showed that those in prove-2 who did get svr without riba had undetectable at 2 weeks and that is why they are using this as a decision point, or that it will take 3 drugs as idix management suggests