New therapeutic strategies in HCV: second-generation protease inhibitors

Authors


Correspondence

David R Nelson, MD

Professor of Medicine and Associate Dean, University of Florida, Gainesville, FL, USA

Tel: +352 273 9500

Fax: +352 846 1973

e-mail: nelsodr@ufl.edu

Abstract

Telaprevir and boceprevir are the first direct-acting antiviral agents approved for use in HCV treatment and represent a significant advance in HCV therapy. However, these first-generation drugs also have significant limitations related to thrice-daily dosing, clinically challenging side-effect profiles, low barriers to resistance and a lack of pan-genotype activity. A second wave of protease inhibitors are in phase II and III trials and promise to provide a drug regimen with a better dosing schedule and improved tolerance. These second-wave protease inhibitors will probably be approved in combination with PEG-IFN and Ribavirin (RBV), as well as future all-oral regimens. The true second-generation protease inhibitors are in earlier stages of development and efficacy data are anxiously awaited as they may provide pan-genotypic antiviral activity and a high genetic barrier to resistance.

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