First generation agents in this class include telaprevir
and boceprevir. In the group of first generation
agents, they have a high affinity for the NS3/4A
protease but have a higher frequency of developing
resistance within the virus. Simeprevir is considered
to be a second wave of the first generation as it is
considered a noncovalent linear protease inhibitor
which allows for better tolerability7. Other agents that
are part of the second wave of first generation agents
include sovaprevir, faldaprevir, asunaprevir, and
danoprevir. MK-5172 and ACH-2684 are examples of
second generation agents that will provide treatment
options to patients that have developed resistance to
first generation agents.
Of the above agents, their status through the Food
and