Hepatitis C future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-In-Chief: Nina Axiotakis [2]
Future Or Investigational Therapies
The drug viramidine, which is a prodrug of ribavirin which has better targeting for the liver, and therefore may be more effective against hepatitis C for a given tolerated dose, is in phase III experimental trials against hepatitis C. It will be used in conjunction with interferon, in the same manner as ribavirin. However, this drug is not expected to be active against ribavirin-resistant strains, and the use of the drug against infections which have already failed ribavirin/interferon treatment, is unproven.
There are new drugs under development like the protease inhibitors (including VX 950) and polymerase inhibitors (such as NM 283), but development of these is still in the early phase.[1][2] One protease inhibitor, BILN 2061, had to be discontinued due to safety problems early in the clinical testing. Some more modern new drugs that provide some support in treating HCV are Albuferon, Zadaxin, and DAPY. Antisense phosphorothioate oligos have been targeted to hepatitis C[3]. Antisense Morpholino oligos have shown promise in preclinical studies[4] and are in a clinical trial. All of these are not approved remedies and have not yet demonstrated their efficacy in clinical trials. Immunoglobulins against the hepatitis C virus exist and newer types are under development. Thus far, their roles have been unclear as they have not been shown to help in clearing chronic infection or in the prevention of infection with acute exposures (e.g. needlesticks). They do have a limited role in transplant patients.
References
- ↑ Hinrichsen H, Benhamou Y, Wedemeyer H, Reiser M, Sentjens R, Calleja J, Forns X, Erhardt A, Crönlein J, Chaves R, Yong C, Nehmiz G, Steinmann G (2004). "Short-term antiviral efficacy of BILN 2061, a hepatitis C virus serine protease inhibitor, in hepatitis C genotype 1 patients". Gastroenterology. 127 (5): 1347–55. PMID 15521004.
- ↑ Lamarre D, Anderson P, Bailey M, Beaulieu P, Bolger G, Bonneau P, Bös M, Cameron D, Cartier M, Cordingley M, Faucher A, Goudreau N, Kawai S, Kukolj G, Lagacé L, LaPlante S, Narjes H, Poupart M, Rancourt J, Sentjens R, St George R, Simoneau B, Steinmann G, Thibeault D, Tsantrizos Y, Weldon S, Yong C, Llinàs-Brunet M (2003). "An NS3 protease inhibitor with antiviral effects in humans infected with hepatitis C virus". Nature. 426 (6963): 186–9. PMID 14578911 doi:10.1038/nature02099.
- ↑ Zhang H, Hanecak R, Brown-Driver V, Azad R, Conklin B, Fox M, Anderson K (1999). "Antisense oligonucleotide inhibition of hepatitis C virus (HCV) gene expression in livers of mice infected with an HCV-vaccinia virus recombinant". Antimicrob Agents Chemother. 43 (2): 347–53. PMID 9925530.
- ↑ McCaffrey A, Meuse L, Karimi M, Contag C, Kay M (2003). "A potent and specific morpholino antisense inhibitor of hepatitis C translation in mice". Hepatology. 38 (2): 503–8. PMID 12883495.