Review article: HCV – STAT-C era of therapy

Christian Markus Lange (1) , Christoph Sarrazin , Stefan Zeuzem

1 Department of Medicine 1

Background: Numerous “specifically targeted antiviral therapy for hepatitis C” (STAT-C) compounds are currently under development to improve treatment opportunities of chronic hepatitis C virus-(HCV)-infection. Aim: To review the potential of STAT-C agents which are currently under clinical development. Methods: Studies evaluating STAT-C compounds were identified by systematic literature search using PubMed and databases of abstracts presented in English at recent liver and gastroenterology congresses. Results: Numerous STAT-C agents are currently under clinical phase I-III evaluation. Final results of phase II clinical trials evaluating the most advanced compounds telaprevir and boceprevir indicate that the addition of these NS3/4A protease inhibitors to pegylated interferon-alfa and ribavirin strongly improves the chance to achieve a SVR in treatment-naive HCV genotype 1 patient and in treatment-experienced patients. Monotherapy with directly acting antivirals is not possible since it frequently results in the selection of resistant quasispecies and viral breakthrough. NS5B polymerase inhibitors in general have a lower antiviral efficacy than protease inhibitors and their potency to improve SVR rates remains to be established. Conclusion: STAT-C compounds in addition to peg-interferon-alfa and ribavirin are capable to improve SVR rates at least in HCV genotype 1 patients and will therefore be included in future treatment recommendations and guidelines.

Mots clés: Medicine

Christian Markus Lange, Christoph Sarrazin, Stefan Zeuzem. Review article: HCV – STAT-C era of therapy. Alimentary Pharmacology and Therapeutics, 2010, ⟨10.1111/j.1365-2036.2010.04317.x⟩. ⟨hal-00552555⟩