Kanda Tatsuo, Nakamoto Shingo, Wu Shuang, Yokosuka Osamu
Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Ther Clin Risk Manag. 2014 May 24;10:387-94. doi: 10.2147/TCRM.S50170. eCollection 2014.
Chronic hepatitis C virus (HCV) infection causes end-stage liver diseases and hepato cellular carcinoma. In the USA, Canada, and Japan, simeprevir - one of the second-generation HCV NS3/4A protease inhibitors - in combination with peginterferon α-2a or 2b plus ribavirin has recently been approved for HCV genotype 1-infected patients and is now used in daily clinical practice. This review summarizes the mechanism of action of simeprevir and the results of clinical trials of simeprevir and peginterferon plus ribavirin for HCV genotype 1 patients. In general, the simeprevir and peginterferon plus ribavirin treatment is highly effective and its adverse events are similar to those of peginterferon plus ribavirin only, the exception being milder, reversible jaundice. In the near future, the development of interferon-free regimens with simeprevir is expected. Careful attention should be paid to new results of clinical trials with simeprevir.
慢性丙型肝炎病毒（HCV）感染可导致终末期肝病和肝细胞癌。在美国、加拿大和日本，第二代HCV NS3/4A蛋白酶抑制剂之一的simeprevir与聚乙二醇干扰素α-2a或2b加利巴韦林联合使用，最近已被批准用于HCV基因1型感染患者，目前已应用于日常临床实践。本综述总结了simeprevir的作用机制以及simeprevir与聚乙二醇干扰素加利巴韦林用于HCV基因1型患者的临床试验结果。总体而言，simeprevir与聚乙二醇干扰素加利巴韦林联合治疗非常有效，其不良事件仅与聚乙二醇干扰素加利巴韦林的不良事件相似，例外情况是黄疸较轻且可逆。在不久的将来，有望开发出不含干扰素的simeprevir治疗方案。应密切关注simeprevir临床试验的新结果。
