Grazoprevir

Grazoprevir
Clinical data
Trade names	Zepatier (combination with elbasvir)
Other names	MK-5172
License data	EU EMA: by INN;
Routes of; administration	Oral
ATC code	J05AP11 (WHO) ; J05AP54 (WHO) (combination with elbasvir);
Legal status
Legal status	US: ℞-only;
Pharmacokinetic data
Protein binding	98.8%
Metabolism	CYP3A4
Elimination half-life	31 hours
Excretion	>90% via faeces, <1% via urine
Identifiers
	IUPAC name (1R,18R,20R,24S,27S)-N-{(1R,2S)-1-[(Cyclopropylsulfonyl)carbamoyl]-2-vinylcyclopropyl}-7-methoxy-24-(2-methyl-2-propanyl)-22,25-dioxo-2,21-dioxa-4,11,23,26-tetraazapentacyclo[24.2.1.03,12.05,10.0 18,20]nonacosa-3,5,7,9,11-pentaene-27-carboxamide;
CAS Number	1350514-68-9;
PubChem CID	44603531;
DrugBank	DB11575;
ChemSpider	28506694;
UNII	8YE81R1X1J;
KEGG	D10639;
ChEBI	CHEBI:132975 ;
CompTox Dashboard (EPA)	DTXSID50159234 ;
Chemical and physical data
Formula	C38H50N6O9S
Molar mass	766.91 g·mol−1
3D model (JSmol)	;
	SMILES O=C1C(C(C)(C)C)NC(=O)OC3CC3CCCCCc2nc4ccc(OC)cc4nc2OC(C6)CN1C6C(=O)NC5(CC5C=C)C(=O)NS(=O)(=O)C7CC7;
	InChI InChI=1S/C38H50N6O9S/c1-6-22-19-38(22,35(47)43-54(49,50)25-13-14-25)42-32(45)29-18-24-20-44(29)34(46)31(37(2,3)4)41-36(48)53-30-16-21(30)10-8-7-9-11-27-33(52-24)40-28-17-23(51-5)12-15-26(28)39-27/h6,12,15,17,21-22,24-25,29-31H,1,7-11,13-14,16,18-20H2,2-5H3,(H,41,48)(H,42,45)(H,43,47)/t21-,22-,24-,29+,30-,31-,38-/m1/s1; Key:OBMNJSNZOWALQB-NCQNOWPTSA-N;

Grazoprevir is a drug^[1] approved for the treatment of hepatitis C. It was developed by Merck and completed Phase III trials, used in combination with the NS5A replication complex inhibitor elbasvir under the trade name Zepatier, either with or without ribavirin.^[2]

Grazoprevir is a second generation hepatitis C virus protease inhibitor acting at the NS3/4A protease targets.^[3] It has good activity against a range of HCV genotype variants, including some that are resistant to most currently used antiviral medications.^[4]^[5]

^ "FDA approves Zepatier for treatment of chronic hepatitis C genotypes 1 and 4". Food and Drug Administration. 2018-11-03.
^ Lawitz E, Gane E, Pearlman B, Tam E, Ghesquiere W, Guyader D, et al. (March 2015). "Efficacy and safety of 12 weeks versus 18 weeks of treatment with grazoprevir (MK-5172) and elbasvir (MK-8742) with or without ribavirin for hepatitis C virus genotype 1 infection in previously untreated patients with cirrhosis and patients with previous null response with or without cirrhosis (C-WORTHY): a randomised, open-label phase 2 trial". Lancet. 385 (9973): 1075–86. doi:10.1016/S0140-6736(14)61795-5. PMID 25467591.
^ Harper S, McCauley JA, Rudd MT, Ferrara M, DiFilippo M, Crescenzi B, et al. (April 2012). "Discovery of MK-5172, a Macrocyclic Hepatitis C Virus NS3/4a Protease Inhibitor". ACS Medicinal Chemistry Letters. 3 (4): 332–6. doi:10.1021/ml300017p. PMC 4025840. PMID 24900473.
^ Summa V, Ludmerer SW, McCauley JA, Fandozzi C, Burlein C, Claudio G, et al. (August 2012). "MK-5172, a selective inhibitor of hepatitis C virus NS3/4a protease with broad activity across genotypes and resistant variants". Antimicrobial Agents and Chemotherapy. 56 (8): 4161–7. doi:10.1128/AAC.00324-12. PMC 3421554. PMID 22615282.
^ Gentile I, Buonomo AR, Borgia F, Zappulo E, Castaldo G, Borgia G (May 2014). "MK-5172 : a second-generation protease inhibitor for the treatment of hepatitis C virus infection". Expert Opinion on Investigational Drugs. 23 (5): 719–28. doi:10.1517/13543784.2014.902049. PMID 24666106. S2CID 207477059.

[1] "FDA approves Zepatier for treatment of chronic hepatitis C genotypes 1 and 4". Food and Drug Administration. 2018-11-03.

[2] Lawitz E, Gane E, Pearlman B, Tam E, Ghesquiere W, Guyader D, et al. (March 2015). "Efficacy and safety of 12 weeks versus 18 weeks of treatment with grazoprevir (MK-5172) and elbasvir (MK-8742) with or without ribavirin for hepatitis C virus genotype 1 infection in previously untreated patients with cirrhosis and patients with previous null response with or without cirrhosis (C-WORTHY): a randomised, open-label phase 2 trial". Lancet. 385 (9973): 1075–86. doi:10.1016/S0140-6736(14)61795-5. PMID 25467591.

[3] Harper S, McCauley JA, Rudd MT, Ferrara M, DiFilippo M, Crescenzi B, et al. (April 2012). "Discovery of MK-5172, a Macrocyclic Hepatitis C Virus NS3/4a Protease Inhibitor". ACS Medicinal Chemistry Letters. 3 (4): 332–6. doi:10.1021/ml300017p. PMC 4025840. PMID 24900473.

[4] Summa V, Ludmerer SW, McCauley JA, Fandozzi C, Burlein C, Claudio G, et al. (August 2012). "MK-5172, a selective inhibitor of hepatitis C virus NS3/4a protease with broad activity across genotypes and resistant variants". Antimicrobial Agents and Chemotherapy. 56 (8): 4161–7. doi:10.1128/AAC.00324-12. PMC 3421554. PMID 22615282.

[5] Gentile I, Buonomo AR, Borgia F, Zappulo E, Castaldo G, Borgia G (May 2014). "MK-5172 : a second-generation protease inhibitor for the treatment of hepatitis C virus infection". Expert Opinion on Investigational Drugs. 23 (5): 719–28. doi:10.1517/13543784.2014.902049. PMID 24666106. S2CID 207477059.

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