Review article: specifically targeted anti‐viral therapy for hepatitis C – a new era in therapy

• Published in: Alimentary pharmacology & therapeutics Vol. 32; no. 1; pp. 14 - 28
• Main Authors: Lange, C. M., Sarrazin, C., Zeuzem, S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2010; Blackwell
• Subjects: Antiviral Agents - therapeutic use; Biological and medical sciences; Digestive system; Drug Therapy, Combination; Gastroenterology. Liver. Pancreas. Abdomen; Hepacivirus - drug effects; Hepatitis C virus; Hepatitis C, Chronic - drug therapy; Human viral diseases; Humans; Infectious diseases; Medical sciences; Pharmacology. Drug treatments; Randomized Controlled Trials as Topic; Treatment Outcome; Viral diseases; Viral hepatitis; Viral Load; Performance evaluation; Drug; Alpha interferon; Targeted therapy; Treatment efficiency; Pharmacotherapy; Hepatic disease; Genotype; Review; Ribavirin; Infection; Viral hepatitis; Treatment; Viral disease; Nucleoside analog; Digestive diseases; Antiviral; Pegylated form; Bibliographic review; Viral hepatitis C
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2010.04317.x

Aliment Pharmacol Ther 2010; 32: 14–28 Summary Background  Novel, directly acting anti‐viral agents, also named ‘specifically targeted anti‐viral therapy for hepatitis C’ (STAT‐C) compounds, are currently under development. Aim  To review the potential of STAT‐C agents which are currently under clinical development, with a focus on agents that target HCV proteins. Methods  Studies evaluating STAT‐C compounds were identified by systematic literature search using PubMed as well as databases of s presented in English at recent liver and gastroenterology congresses. Results  Numerous directly‐acting anti‐viral agents are currently under clinical phase I–III evaluation. Final results of phase II clinical trials evaluating the most advanced compounds telaprevir and boceprevir indicate that the addition of these NS3/4A protease inhibitors to pegylated interferon‐alfa and ribavirin strongly improves the chance to achieve a SVR in treatment‐naive HCV genotype 1 patient as well as in prior nonresponders and relapsers to standard therapy. Monotherapy with directly acting anti‐virals is not suitable. NS5B polymerase inhibitors in general have a lower anti‐viral efficacy than protease inhibitors. Conclusions  STAT‐C compounds in addition to pegylated interferon‐alfa and ribavirin can improve SVR rates at least in HCV genotype 1 patients. Future research needs to evaluate whether a SVR can be achieved by combination therapies of STAT‐C compounds in interferon‐free regimens.