抗丙型肝炎病毒药索非布韦的临床研究进展

发布时间：2019-06-05 19:02

【摘要】：目的:综述抗丙型肝炎病毒(HCV)药索非布韦的临床研究进展。方法:以"Sofosbuvir""索非布韦""索氟布韦""丙型肝炎"和"NS5B聚合酶抑制剂"等为关键词,组合检索2010年1月至2015年2月Pub Med、万方、维普、中国知网等数据库,对索非布韦的临床药理(作用机制、药动学、药物相互作用、耐药性)、适用特殊人群、临床试验及安全性评价等内容进行综述。结果:共检索到相关文献76条,其中有效文献20条。作用机制方面,索非布韦通过与HCV的RNA核苷酸竞争HCV特异性NS5B聚合酶活化位点而发挥抗病毒作用,给药剂量为400 mg/d时对病毒的抑制作用最佳。临床应用方面,索非布韦适用于HCV初治患者和既往干扰素治疗失败的患者,不同HCV基因型感染可采用不同的给药方案;索非布韦对HCV感染合并肝硬化、肝脏移植和人类免疫缺陷病毒感染患者也有效,且给药时无需调整剂量。此外,索非布韦的耐药性较好、药物相互作用少、不良事件发生率较低。结论:索非布韦用于慢性HCV感染治疗,具有病毒学应答率高、适用人群广、不良反应发生率低、给药方式简单等特点,相信在未来会拥有良好的应用前景。
[Abstract]:Objective: to review the clinical research progress of sofebuvir, an anti-hepatitis C virus (HCV) drug. Methods: using "Sofosbuvir", "sofebwe", "sofebuvir", "hepatitis C" and "NS5B polymerase inhibitor" as keywords, the databases of Pub Med, Wanfang, Weipu and China knowledge Network from January 2010 to February 2015 were searched. The clinical pharmacology (mechanism of action, pharmacokinetics, drug interaction, drug resistance), application of special population, clinical trial and safety evaluation of sofebuvir were reviewed. Results: a total of 76 related literatures were searched, of which 20 were effective. In terms of mechanism, Sofebwe played an antiviral role by competing with RNA nucleotides of HCV for HCV specific NS5B polymerase activation sites, and the inhibitory effect on the virus was the best at the dose of 400 mg/d. In clinical application, sofebuvir is suitable for newly treated patients with HCV and patients with failed interferon therapy. Different HCV genotypic infections can be treated with different drug administration schemes. Sofebuvir is also effective in patients with HCV infection complicated with liver cirrhosis, liver transplantation and human immunodeficiency virus infection, and there is no need to adjust the dose during administration. In addition, the drug resistance of sofebuvir was good, the drug interaction was less, and the incidence of adverse events was low. Conclusion: sofebuvir is used in the treatment of chronic HCV infection with the characteristics of high virological response rate, wide application population, low incidence of adverse reactions and simple administration. It is believed that sofebuvir will have a good application prospect in the future.
【作者单位】：台州恩泽医疗中心(集团)恩泽医院药剂科;杭州市余杭区第二人民医院药剂科;
【分类号】：R969.3

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