Boceprevir: an oral protease inhibitor for the treatment of chronic HCV infection

Expert Rev Anti Infect Ther. 2012 Mar;10(3):269-79. doi: 10.1586/eri.12.8.

Abstract

Chronic hepatitis C (CHC) virus infection affects more than 170 million people globally. The aim of treatment of CHC is to affect sustained elimination of the virus (a sustained virological response [SVR]). The success and duration of therapy with interferon is dependent on HCV genotype. The current standard of care comprises combined treatment with pegylated interferon and ribavirin. Rates of SVR in patients with genotype 1 infection, the least responsive group, are less than 50%. Boceprevir is a ketoamide protease inhibitor that binds reversibly to the HCV nonstructural NS3 protease active site inhibiting intracellular viral replication. Phase III clinical studies have demonstrated that, in combination with the current standard of care, boceprevir significantly increases the SVR rate in both treatment-naive and previously treated patients with genotype 1 CHC. Both the US FDA and EMA have approved boceprevir for the treatment of genotype 1 CHC: the first directly-acting antiviral drug to be licensed for this indication. This article will review the pharmacology and pharmacodynamics of boceprevir, the efficacy and safety of the drug, and explore possible future developments in the management of CHC.

Publication types

  • Review

MeSH terms

  • Adult
  • Antiviral Agents* / administration & dosage
  • Antiviral Agents* / adverse effects
  • Antiviral Agents* / pharmacology
  • Antiviral Agents* / therapeutic use
  • Drug Therapy, Combination
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / therapeutic use
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / therapeutic use
  • Proline / administration & dosage
  • Proline / adverse effects
  • Proline / analogs & derivatives*
  • Proline / pharmacology
  • Proline / therapeutic use
  • Protease Inhibitors* / administration & dosage
  • Protease Inhibitors* / adverse effects
  • Protease Inhibitors* / pharmacology
  • Protease Inhibitors* / therapeutic use
  • Randomized Controlled Trials as Topic
  • Ribavirin / administration & dosage
  • Ribavirin / therapeutic use
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Protease Inhibitors
  • Polyethylene Glycols
  • Ribavirin
  • N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
  • Proline