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

Authors


  • This commissioned review article was subject to full peer-review.

Dr S. Zeuzem, Klinikum der J. W. Goethe-Universität Frankfurt am Main Medizinische Klinik 1, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
E-mail: zeuzem@em.uni-frankfurt.de

Abstract

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 abstracts 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.

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