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The Discovery and Development of Boceprevir: A Novel, First-generation Inhibitor
of the Hepatitis C Virus NS3/4A Serine Protease
#MMPMID26357603
Howe AY
; Venkatraman S
J Clin Transl Hepatol
2013[Sep]; 1
(1
): 22-32
PMID26357603
show ga
An estimated 2-3% of the world's population is infected with hepatitis C virus
(HCV), making it a major global health problem. Consequently, over the past 15
years, there has been a concerted effort to understand the pathophysiology of HCV
infection and the molecular virology of replication, and to utilize this
knowledge for the development of more effective treatments. The virally encoded
non-structural serine protease (NS3) is required to process the HCV polyprotein
and release the individual proteins that form the viral RNA replication
machinery. Given its critical role in the replication of HCV, the NS3 protease
has been recognized as a potential drug target for the development of selective
HCV therapies. In this review, we describe the key scientific discoveries that
led to the approval of boceprevir, a first-generation, selective, small molecule
inhibitor of the NS3 protease. We highlight the early studies that reported the
crystal structure of the NS3 protease, its role in the processing of the HCV
polyprotein, and the structural requirements critical for substrate cleavage. We
also consider the novel attributes of the NS3 protease-binding pocket that
challenged development of small molecule inhibitors, and the studies that
ultimately yielded milligram quantities of this enzyme in a soluble, tractable
form suitable for inhibitor screening programs. Finally, we describe the
discovery of boceprevir, from the early chemistry studies, through the
development of high-throughput assays, to the phase III clinical development
program that ultimately provided the basis for approval of this drug. This latest
phase in the development of boceprevir represents the culmination of a major
global effort to understand the pathophysiology of HCV and develop small molecule
inhibitors for the NS3 protease.