Cutting-edge pharmacotherapy for hepatitis C virus infection: a comprehensive review.

IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Expert Opinion on Pharmacotherapy Pub Date : 2024-08-01 Epub Date: 2024-08-26 DOI:10.1080/14656566.2024.2396024
Chen-Hua Liu, Yu-Ping Chang, Jia-Horng Kao
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Abstract

Introduction: Pharmacotherapy against hepatitis C virus (HCV) infection has tremendously improved since the advent of interferon (IFN)-free direct-acting antivirals (DAAs). Additionally, fixed-dose pangenotypic DAAs, which are safe, potent, easy for use, and can cover a wide spectrum of patients, have been recommended by professional guidelines for DAA-naïve and DAA-experienced patients with HCV.

Areas covered: We review the pharmacokinetics, pharmacodynamics, and potential drug-drug interactions (DDIs) of fixed-dose pangenotypic DAA regimens, including glecaprevir/pibrentasvir (GLE/PIB), sofosbuvir/velpatasvir (SOF/VEL), and sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX). Additionally, we summarize the efficacy and safety of these regimens in clinical trials as well as real-world studies for treating different populations. Lastly, we discuss unmet medical needs in managing HCV in the era of fixed-dose pangenotypic DAAs.

Expert opinion: Protease inhibitors (PIs), including GLE and VOX, are prone to have more frequent DDIs, compared to the non-structural (NS) 5A and 5B inhibitors. These regimens are generally well tolerated and can be applied to different populations, except for the contraindicated use of PI-containing DAA regimens in decompensated cirrhosis. Using the first-line GLE/PIB and SOF/VEL can eradicate HCV in more than 95% of DAA-naïve patients across different populations. The viral cure usually exceeds 95% when using the rescue SOF/VEL/VOX regimen for prior DAA failures.

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丙型肝炎病毒感染的前沿药物疗法:全面回顾。
简介:自不含干扰素(IFN)的直接作用抗病毒药物(DAAs)问世以来,丙型肝炎病毒(HCV)感染的药物治疗得到了极大改善。此外,固定剂量的泛基因型 DAAs 安全、有效、易于使用且可覆盖广泛的患者,已被专业指南推荐用于 DAA 不适用和有 DAA 经验的 HCV 患者:我们回顾了固定剂量泛基因型DAA方案的药代动力学、药效学和潜在的药物相互作用(DDIs),包括格列卡韦/匹布伦达韦(GLE/PIB)、索非布韦/韦帕他韦(SOF/VEL)和索非布韦/韦帕他韦/沃西普瑞韦(SOF/VEL/VOX)。此外,我们还总结了这些方案在临床试验和实际研究中治疗不同人群的疗效和安全性。最后,我们讨论了在固定剂量泛基因型DAAs时代管理HCV方面尚未满足的医疗需求:蛋白酶抑制剂(PIs),包括 GLE 和 VOX,与非结构性(NS)5A 和 5B 抑制剂相比,容易出现更频繁的 DDIs。除了失代偿期肝硬化患者禁用含 PI 的 DAA 方案外,这些方案一般耐受性良好,可用于不同人群。在不同人群中,使用一线GLE/PIB和SOF/VEL可使95%以上的DAA无效患者根除HCV。在使用 SOF/VEL/VOX 挽救方案治疗之前 DAA 治疗失败的患者时,病毒治愈率通常超过 95%。
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来源期刊
CiteScore
5.60
自引率
3.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Expert Opinion on Pharmacotherapy is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles and original papers on newly approved/near to launch compounds mainly of chemical/synthetic origin, providing expert opinion on the likely impact of these new agents on existing pharmacotherapy of specific diseases.
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