Sofosbuvir + velpatasvir + voxilaprevir for the treatment of hepatitis C infection

Expert Opin Pharmacother. 2018 May;19(7):749-757. doi: 10.1080/14656566.2018.1459567. Epub 2018 Apr 10.

Abstract

Hepatitis C is a disease with a significant global impact. Over the last several years, the treatment of the disease has been revolutionized. Therapy has transformed over the last several years with the approval of second generation direct acting antivirals, and currently utilized medications for the treatment of hepatitis C are significantly more efficacious with better safety profiles than previously approved treatments. Treatment for individuals who have failed therapy on direct acting antivirals has, until recently, been complex and difficult to treat, but the approval of sofosbuvir/velpatasvir/voxilaprevir represents a new therapeutic option for these individuals. Areas covered: Sofosbuvir/velpatasvir/voxilaprevir is a recently approved therapeutic combination for the treatment of hepatitis C. This article reviews the studies leading to the approval of the combination, and its efficacy and safety profile. Expert opinion: Sofosbuvir/velpatasvir/voxilaprevir fills one of the previously unfilled niches for the treatment of hepatitis C, that of the treatment of individuals who have failed therapy with resistant virus. With the filling of this niche, there appears to be a general slowing of the development of new therapeutics. Although understandable, in the long term, there are considerable risks associated with the decreased development of new drugs to treat hepatitis C.

Keywords: Hepatitis C; NS3 protease inhibitor; NS5A inhibitor; NS5B polymerase inhibitor; sofosbuvir; velpatasvir; voxilaprevir.

MeSH terms

  • Aminoisobutyric Acids
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Carbamates / pharmacology
  • Carbamates / therapeutic use*
  • Cyclopropanes
  • Drug Therapy, Combination / methods*
  • Hepatitis C, Chronic / drug therapy*
  • Heterocyclic Compounds, 4 or More Rings / pharmacology
  • Heterocyclic Compounds, 4 or More Rings / therapeutic use*
  • Humans
  • Lactams, Macrocyclic
  • Leucine / analogs & derivatives
  • Macrocyclic Compounds / pharmacology
  • Macrocyclic Compounds / therapeutic use*
  • Proline / analogs & derivatives
  • Quinoxalines
  • Sofosbuvir / pharmacology
  • Sofosbuvir / therapeutic use*
  • Sulfonamides / pharmacology
  • Sulfonamides / therapeutic use*

Substances

  • Aminoisobutyric Acids
  • Antiviral Agents
  • Carbamates
  • Cyclopropanes
  • Heterocyclic Compounds, 4 or More Rings
  • Lactams, Macrocyclic
  • Macrocyclic Compounds
  • Quinoxalines
  • Sulfonamides
  • voxilaprevir
  • Proline
  • Leucine
  • velpatasvir
  • Sofosbuvir