摘要
约2.3%的世界人口感染丙型乙肝病毒(HCV), 并且病人具有很高的患肝硬化及并发症的危险。目前的治疗方案主要基于聚乙二醇干扰素,利巴韦林和(仅适用于基因1型感染病人)一种蛋白酶抑制剂(boceprevir 或者telaprevir)的联合应用。结果是所有这些组合存在干扰素的局限性。实际上,他们在失代偿性疾病及一些严重的共存病中是禁忌药物,其与副作用的高发生率联系在一起。而且,对于一些晚期疾病缺乏疗效。由于病毒完全消除与增加疾病的存活率相关,为了克服目前有效治疗的缺点 ,数种具有潜力的分子处于临床开发中。该综述专注于强大的蛋白酶NS3抑制剂ABT-450的药效学、药动学、安全性和耐受性。ABT-450是细胞色素P450的底物,因此与细胞色素P450抑制剂利托那韦联合用药,可以显著地提高ABT-450的血浆浓度和半衰期,每天允许给药1次。不同剂量单药给药3天,ABT-450可引起平均最大病毒量减少4倍。有趣地是,高剂量的ABT-450可以减少和延迟耐受性突变体的发展。与其他直接抗病毒药物联用,在初治和复治的基因型1患者持续病毒学反应率高达90%-95%,且具有好的耐受性。总之,ABT-450是在治疗慢性HCV感染的无干扰素组合疗法中十分优秀的一个组分。
关键词: ABT-072
Current Medicinal Chemistry
Title:ABT-450: A Novel Protease Inhibitor for the Treatment of Hepatitis C Virus Infection
Volume: 21 Issue: 28
Author(s): Ivan Gentile, Federico Borgia, Antonio Riccardo Buonomo, Emanuela Zappulo, Giuseppe Castaldo and Guglielmo Borgia
Affiliation:
关键词: ABT-072
摘要: About 2.3% of the world’s population is infected with hepatitis C virus (HCV) and patients have a high risk of developing liver cirrhosis and its complications. Current therapeutic strategies are based on a combination of pegylatedinterferon, ribavirin and (only for patients with genotype 1 infection) a protease inhibitor (boceprevir or telaprevir). Consequently, all these combinations have the limitations of interferon. In fact, they are contraindicated in decompensated disease and in subjects with severe comorbidities, and are associated with a high rate of side effects. Moreover, they are poorly effective in advanced disease. As complete viral eradication is associated with improved disease-free survival, several molecules are under clinical development for their potential to overcome the drawbacks of currently available treatments. This review focuses on the pharmacodynamics, pharmacokinetics, safety and tolerability of ABT-450, a potent inhibitor of non-structural 3 protease. ABT-450 is a substrate of cytochrome P450; hence its co-administration with ritonavir, a cytochrome P450 inhibitor, dramatically increases the plasma concentration and half-life of ABT-450 and allows once-daily administration. Given in monotherapy for 3 days at different doses, ABT-450 causes a mean maximum viral decline of about 4 logs. Interestingly, high doses of ABT-450 are associated with a reduced and delayed development of resistance-conferring mutations. Given in combination with other direct antiviral drugs, the sustained response rate reaches 90-95% in both naïve and treatment-experienced genotype 1 patients, and tolerability is good. In conclusion, ABT-450 is an excellent component of interferon-free combinations for the treatment of chronic HCV infection.
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Gentile Ivan, Borgia Federico, Buonomo Riccardo Antonio, Zappulo Emanuela, Castaldo Giuseppe and Borgia Guglielmo, ABT-450: A Novel Protease Inhibitor for the Treatment of Hepatitis C Virus Infection, Current Medicinal Chemistry 2014; 21 (28) . https://dx.doi.org/10.2174/0929867321666140706125950
DOI https://dx.doi.org/10.2174/0929867321666140706125950 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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