A New Potent NS5A Inhibitor in the Management of Hepatitis C Virus: Ravidasvir

Background: Chronic hepatitis C virus (HCV) is a worldwide health problem that can lead to liver cirrhosis, liver cell failure and numerous subsequent complications such as hepatocellular carcinoma. Till the near past, pegylated interferon was the standard of care therapy. However, it was associated with suboptimal success rates and many side effects. Thereafter, direct antiviral agents (DAA) appeared and played the key role in management of HCV. One of those recent DAAs is ravidasvir. Summary: It is a potent NS5A inhibitor that was formerly known as PPI-668. It is produced by the cooperation of Presidio pharmaceuticals and Pharco International pharmaceutical company. Since its first production, it has been enrolled in different successive clinical trials. Phase 1 and 2 trials confirmed its safety and tolerability and its great efficacy in suppressing viral loads in short periods. It has a pangenotypic activity with favorable pharmacokinetic properties. Ravidasvir inhibits the replication of HCV variants that develop resistance mutations for different DAA classes. Even more, HCV variants that had reduced susceptibility to ravidasvir are completely susceptible to other DAA. Finally, a large multicenteric registrational phase 3 clinical trial that included large percentages of difficult to treat patients (such as cirrhotic and interferon experienced patients) has been fully accomplished and proved great SVR12 rates. Conclusion: Ravidasvir is a potent new NS5A inhibitor with excellent safety and tolerability in management of genotype 4 HCV patients.