What is the role of combined elbasvir/grazoprevir (Zepatier)in the treatment of hepatitis C virus (HCV) infection?

Updated: Dec 09, 2020
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In January 2016, a fixed-dose combination pill of elbasvir (an NS5A replication complex inhibitor) and grazoprevir (an NS3/4A protease inhibitor) received FDA approval for use in patients with genotype 1 or 4 infection. [27] The elbasvir/grazoprevir combination (Zepatier)—with or without ribavirin— was also approved for use in patients with HCV/HIV coinfection and in patients with compensated cirrhosis. Use in patients with decompensated cirrhosis was contraindicated owing to concerns that such patients could experience high grazoprevir plasma concentrations, putting them at risk for liver dysfunction. Importantly, elbasvir/grazoprevir received approval for use in patients with severe renal impairment, including patients underoging hemodialysis.


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