Special Issue: Biomarkers in Liver Disease, In My Opinion, Emerging Liver Scholars & Implications of Translational Research
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Volume 8, Issue 3 Pages 59 - 82, September 2016
Article Of Interest
The era of first direct-acting antiviral agents: What did we learn?
Omar Y. Mousa, Surakit Pungpapong and Victor Ankoma-Sey
Version of Record online: 2 OCT 2016 | DOI: 10.1002/cld.574
The introduction of oral direct-acting antiviral agents (DAAs) revolutionized the treatment of patients infected with hepatitis C virus (HCV). The first class of DAAs to be approved by the US Food and Drug Administration were the protease inhibitors (PIs), telaprevir (TVR) and boceprevir (BOC). Because of their low potency and low genetic barrier to develop resistance-associated variants (RAVs), these drugs were approved to be used in combination with pegylated interferon-α and ribavirin (PR). Even though both PIs had significant issues related to safety and efficacy, they heralded a new era in therapy for chronic HCV infection.[1, 2] Like shooting stars in the night sky, they shone brightly yet briefly, illuminating the path for future advances in the treatment of HCV. Within 3 years of their approval to be available in the United States, both TVR and BOC were discontinued from that market. They are no longer recommended by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases for the treatment of HCV because they have been superseded by more effective and safer second-generation PIs and/or other classes of DAAs. So what did we learn from those shooting stars, TVR and BOC?
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