title: Ombitasvir (ABT-267), a novel NS5A inhibitor for the treatment of hepatitis C.
abstract: BACKGROUND
  Chronic hepatitis C infection is a global disease with 160 million people infected worldwide. Until recently, therapy was characterized by long duration, suboptimal success rates and significant adverse drug reactions. The development of direct-acting antivirals initiated a dramatic change in the treatment of hepatitis C.
  
  
  METHODS
  This review covers the development of the novel NS5A inhibitor ombitasvir (ABT-267) and its clinical evaluation in Phase I to III trials as monotherapy and in combination with the NS3/4A inhibitor ABT-450/r and the non-nucleoside NS5B inhibitor dasabuvir (ABT-333) ± ribavirin.
  
  
  CONCLUSIONS
  Ombitasvir (ABT-267) is a potent inhibitor of the hepatitis C virus protein NS5A, has favorable pharmacokinetic characteristics and is active in the picomolar range against genotype 1 - 6. In patients with genotype 1 and 4, 12-week combination treatment with ombitasvir, dasabuvir and ABT-450/r plus ribavirin was highly effective and resulted in 12-week sustained virological response rates higher than 95% in treatment-naöve and treatment-experienced patients. In liver transplant recipients with genotype 1 hepatitis C, success rates in the same range can be expected after 24 weeks of treatment according to preliminary trial results. Genotype 1a patients with compensated cirrhosis who were prior nonresponders benefit from a treatment duration of 24 weeks.
authors.affiliation: University Clinic for Visceral Surgery and Medicine, Inselspital, Hepatology , Bern , Switzerland +41 31 632 47 13 ; +41 31 632 74 89 ; guido.stirnimann@insel.ch.
authors.forename: Guido
authors.initials: G
authors.lastname: Stirnimann
mesh_terms: D000813:Anilides / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002219:Carbamates / Q000494:pharmacology / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000821:virology; D006801:Humans; D011392:Proline; D012254:Ribavirin / Q000627:therapeutic use; D014633:Valine; D017361:Viral Nonstructural Proteins / Q000037:antagonists & inhibitors / Q000737:chemistry / Q000378:metabolism; D012324:RNA-Dependent RNA Polymerase
chemical_list: D000813:Anilides; D000998:Antiviral Agents; D002219:Carbamates; D011392:Proline; D012254:Ribavirin; D014633:Valine; D017361:Viral Nonstructural Proteins; C586094:ombitasvir; C087036:NS-5 protein, hepatitis C virus; D012324:RNA-Dependent RNA Polymerase
keywords: ABT-267; NS5A; NS5A inhibitor; direct-acting antivirals; hepatitis C; ombitasvir; treatment