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

ABSTRACT

Introduction: 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

Acknowledgments

The authors wish to thank Dr. Wei Li for providing ChemDraw software, and Dr. Wei Li and Hanxuan Li for assistance with using the ChemDraw software.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. One referee has been an investigator of clinical trials sponsored by Gilead Sciences, AbbVie, Merck & Co, Janssen Pharmaceuticals. They have also received honoraria for continuing medical education and advisory board lectures from Gilead Canada, Merck Canada, AbbVie Canada. Another referee declares that they have been a consultant and adviser and has received research grants from Gilead Sciences.

Additional information

Funding

The authors acknowledge financial support from the National Institutes of Health Grants AA022063 and DA042374.