Glecaprevir (ABT-493) is a hepatitis C virus (HCV) NS3/4A serine protease inhibitor developed by AbbVie. It is clinically used in a fixed-dose combination with pibrentasvir (GLE/PIB, brand name: Mavyret®), providing a pan-genotypic, short-course, and highly effective first-line treatment for hepatitis C. I. Basic Information
Generic Name: Glecaprevir
Code: ABT-493
CAS Number: 1365970-03-1
Molecular Formula: C₃₈H₄₆F₄N₆O₉S
Originator: Enanta Pharmaceuticals (Research), AbbVie (Development/Commercialization)
Clinical Form: Fixed-dose combination (GLE 100 mg + PIB 40 mg/tablet)
II. Mechanism of Action
Target: HCV NS3/4A protease (a key enzyme essential for viral replication)
Mechanism: Inhibits NS3/4A protease activity, blocking the cleavage and maturation of HCV polyproteins, preventing viral replication and assembly.
Combination Synergy: Used in combination with Pibrentasvir (PIB, an NS5A inhibitor), providing dual-target blockade, significantly improving cure rates and reducing the risk of resistance.
III. Core Indications (GLE/PIB Combination)
For patients aged 3 years and older with HCV genotypes 1–6, without cirrhosis or with compensated cirrhosis (Child-Pugh A):
Treatment-naïve patients: All genotypes (1–6), 8-week treatment course, SVR₁₂ ≈ 95%–100%
Treatment-experienced patients: Genotype 1, previously treated with only NS5A inhibitors or NS3/4A inhibitors (not both simultaneously), 16-week treatment course
Special populations: Renal impairment/dialysis, children (3–17 years), HIV/HCV co-infection, acute HCV
IV. Dosage and Administration (Adults / Children ≥45 kg)
Dosage: 3 tablets per dose, once daily, taken with food (GLE 300 mg + PIB 120 mg)
Treatment Duration:
Treatment-naïve (without/compensated cirrhosis): 8 weeks
Treatment-experienced (GT1, NS5A or PI failure): 16 weeks
Children (3–12 years, 12–45 kg): [Dosage information for children in this weight range is missing in the original text.] kg): Oral granules, administered according to body weight
V. Pharmacokinetics (GLE)
Absorption: Bioavailability is increased when taken with food.
Protein binding rate: 97.5%
Metabolism: Primarily metabolized by CYP3A
Half-life: Approximately 6 hours
Excretion: 92.1% in feces, 0.7% in urine (no dose adjustment needed for renal impairment)