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Information about Pibrentasvir

Mavyret is an oral, fixed combination of antiviral agents used to treat chronic hepatitis C virus (HCV) infection due to any genotype (1 through 6).

Liver safety of Pibrentasvir

This combination has not been linked to instances or worsening of serum enzymes during therapy or with de novo appearance of clinically apparent liver injury. However, all effective direct acting antiviral agents for hepatitis C are considered capable of causing reactivation of hepatitis B in susceptible patients.

Mechanism of action of Pibrentasvir

Mavyret is the commercial name for a fixed combination of oral antiviral agents used to treat chronic hepatitis C virus infection of all genotypes (1 through 6). The hepatitis C virus encodes several nonstructural (NS) polypeptides that are essential for its replication, including NS3/4 that has protease and helicase activities, NS5A that is a membrane bound polypeptide that is essential for viral replication and NS5B an HCV specific, RNA-dependent, RNA polymerase. These polypeptides are effective targets for antiviral therapy of hepatitis C. Mavyret is a fixed dose combination of glecaprevir (glek a' pre vir) which is a potent HCV NS3/4 protease inhibitor and pibrentasvir (pi brent' as vir) an HCV NS5A inhibitor. In cell culture, each of these agents has potent activity against all genotypes of HCV, but antiviral resistance can arise rapidly with continued exposure to a single agent. The combination of several direct acting agents with different molecular targets allows for a sustained viral suppression while avoiding antiviral resistance. The combination of glecaprevir and pibrentasvir was shown to be very effective in suppressing HCV replication in patients infected with all 6 HCV genotypes and to result in sustained virological responses (SVR) and eradication of HCV in more than 95% of patients when given for 8 weeks or more.

FDA approval information for Pibrentasvir

Pibrentasvir was approved for use in the United States in 2017, the fifth all-oral antiviral combination to receive approval for chronic hepatitis C. It is available as tablets in a fixed dose combination of 100 mg of glecaprevir and 40 mg of pibrentasvir. The recommended dose in adults is 3 tablets once daily for 8 weeks in patients without cirrhosis and for 12 weeks in those with compensated (Class A) cirrhosis. Longer courses of therapy (12 or 16 weeks) are also recommended for patients previously treated with HCV NS3/4 protease inhibitors or NS5A inhibitors. It has not been approved for use in patients with decompensated cirrhosis.

Side effects of Pibrentasvir

Side effects are uncommon but are generally mild and can include fatigue, headache and nausea.

The following are drugs for Hepatitis C:

Interferon Based Therapies

HCV NS5A Inhibitors

HCV NS5B (Polymerase) Inhibitors

HCV Protease Inhibitors

Combination Therapies

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