Danoprevir for the Treatment of Hepatitis C Virus Infection: Design, Development, and Place in Therapy
| Autor: | Erik De Clercq, Guangdi Li, Miao Miao, Xixi Jing |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pharmacology business.industry Hepatitis C virus Ribavirin Danoprevir virus diseases Pharmaceutical Science medicine.disease_cause Virology digestive system diseases Clinical trial 03 medical and health sciences chemistry.chemical_compound Regimen 030104 developmental biology 0302 clinical medicine Tolerability chemistry 030220 oncology & carcinogenesis Drug Discovery medicine Protease inhibitor (pharmacology) Adverse effect business |
| Zdroj: | Drug Design, Development and Therapy. 14:2759-2774 |
| ISSN: | 1177-8881 |
| DOI: | 10.2147/dddt.s254754 |
| Popis: | On June 8, 2018, an NS3/4A protease inhibitor called danoprevir was approved in China to treat the infections of HCV genotype (GT) 1b - the most common HCV genotype worldwide. Based on phase 2 and 3 clinical trials, the 12-week regimen of ritonavir-boosted danoprevir (danoprevir/r) plus peginterferon alpha-2a and ribavirin offered 97.1% (200/206) of sustained virologic response at post-treatment week 12 (SVR12) in treatment-naive non-cirrhotic patients infected with HCV genotype 1b. Adverse events such as anemia, fatigue, fever, and headache were associated with the inclusion of peginterferon alpha-2a and ribavirin in the danoprevir-based regimen. Moreover, drug resistance to danoprevir could be traced to amino acid substitutions (Q80K/R, R155K, D168A/E/H/N/T/V) near the drug-binding pocket of HCV NS3 protease. Despite its approval, the clinical use of danoprevir is currently limited to its combination with peginterferon alpha-2a and ribavirin, thereby driving its development towards interferon-free, ribavirin-free regimens with improved tolerability and adherence. In the foreseeable future, pan-genotypic direct-acting antivirals with better clinical efficacy and less adverse events will be available to treat HCV infections worldwide. |
| Databáze: | OpenAIRE |
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