News Focus
News Focus
icon url

GrthzGd

01/31/14 2:02 PM

#173568 RE: bladerunner1717 #173566

Isn't Karnauskas overstating the need for Ribavarin? Per Abbvie's Pearl II-IV trial results, Riba added little or no benefit for non-cirrhotic patients.
icon url

DewDiligence

01/31/14 2:55 PM

#173572 RE: bladerunner1717 #173566

What's wrong with Karnauskas' analysis?

For starters, she has things backwards vis-à-vis ribavirin necessity—see #msg-96645615.
icon url

dewophile

02/02/14 4:26 PM

#173642 RE: bladerunner1717 #173566

It's superficial. as Dew pointed out the ribavirin advantage (which i agree with the analyst is the most significant difference) will not hold for gen 1b patients and in fact in this group ABBV may hold an edge. for G1a patients ribavirin clearly improves SVR meaningfully (7%) for ABBV's cocktail and is not necessary for most patients on GILD's regimen. However even this is simplistic since some G1a patients who are tx experienced may still be offered ribavirin for what appears to be a small but real benefit of 3-4% SVR. All pts with cirrhosis also will need ribavirin. So there is some nuance that is totally missed in the report.
As for the 8 week regimen there was a 3-4% lower SVR - I wouldnt be surprised if a number of docs and patients who are candidates will just take 12 weeks. i know i would. it's jsut another 4 weeks of pills why risk any lower efficacy.
Her last point regarding breakthroughs is immaterial I think. In the old days since breakthrough is often associated with resistance (unless there was poor compliance) retreating with the same cocktail would not be expected to work, whereas relapsers may benefit from a second course of the regimen for a longer duration. today there are alternative drugs with non overlapping MOA so i really think a GILD failure will use an ABBV regimen next and vice versa, so it shouldn't really matter whether someone failed due to breakthrough or relapse any longer