Telaprevir: a new hope in the treatment of chronic hepatitis C?

More than 180 million people worldwide have chronic hepatitis C (CHC) virus infection, a major cause of liver cirrhosis and its life-threatening complications including liver failure, portal hypertension, and hepatocellular carcinoma. With the current standard of care of pegylated interferon-alpha a...

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Bibliographic Details
Published in:Advances in therapy 2010-08, Vol.27 (8), p.512-522
Main Authors: Fowell, Andrew J., Nash, Kathryn L.
Format: Article
Language:English
Subjects:
Antiviral Agents - therapeutic use
Cardiology
Clinical Trials as Topic
Drug Synergism
Endocrinology
Genetic Predisposition to Disease
Health technology assessment
Hepacivirus - drug effects
Hepacivirus - genetics
Hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - genetics
Hepatitis C, Chronic - physiopathology
Humans
Interferon-alpha - therapeutic use
Internal Medicine
Liver Cirrhosis - etiology
Medicine
Medicine & Public Health
Oligopeptides - pharmacology
Oncology
Pharmacology/Toxicology
Review
Rheumatology
Ribavirin - therapeutic use
Serine Proteinase Inhibitors - genetics
Serine Proteinase Inhibitors - therapeutic use
Treatment Outcome
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Summary:More than 180 million people worldwide have chronic hepatitis C (CHC) virus infection, a major cause of liver cirrhosis and its life-threatening complications including liver failure, portal hypertension, and hepatocellular carcinoma. With the current standard of care of pegylated interferon-alpha and ribavirin (PEG-IFN-α/RBV), the chances of sustained viral clearance or “cure” are only 40%–50% for genotype 1 infection, which is the most common genotype in western populations. Consequently, there has been a drive to develop new agents specifically targeting essential components of the viral life cycle, such as the hepatitis C virus (HCV) NS3/4A serine protease. Perhaps the most advanced HCV protease inhibitor in clinical development is telaprevir, which has been shown to improve treatment outcomes when combined with PEG-IFN-α/RBV in genotype 1 infection, and is currently undergoing phase 3 study. In this review, we summarize the pharmacology, pharmacokinetics, and results of phase 1 and 2 clinical trials of telaprevir, and discuss the likely role of this agent in the future management of CHC.
ISSN:0741-238X
1865-8652
DOI:10.1007/s12325-010-0047-0