A new class of highly potent NS5A inhibitors with an unsymmetric benzimidazole-difluorofluorene-imidazole core and distal [2.2.1]azabicyclic ring system was discovered. Optimization of antiviral potency and pharmacokinetics led to the identification of 39 (ledipasvir, GS-5885). Compound 39 (GT1a replicon EC₅₀ = 31 pM) has an extended plasma half-life of 37–45 h in healthy volunteers and produces a rapid >3 log viral load reduction in monotherapy at oral doses of 3 mg or greater with once-daily dosing in genotype 1a HCV-infected patients. 39 has been shown to be safe and efficacious, with SVR12 rates up to 100% when used in combination with direct-acting antivirals having complementary mechanisms.

中文翻译：

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Ledipasvir (GS-5885) 的发现：一种用于治疗丙型肝炎病毒感染的强效、每日一次的口服 NS5A 抑制剂

发现了一类具有不对称苯并咪唑-二氟芴-咪唑核心和远端[2.2.1]氮杂双环系统的新型高效NS5A抑制剂。抗病毒效力和药代动力学的优化导致鉴定出39 种（ledipasvir，GS-5885）。化合物39 (GT1a 复制子 EC ₅₀ = 31 pM) 在健康志愿者中具有延长的血浆半衰期 37-45 小时，并且在口服剂量为 3 mg 或更大且每天一次的单一疗法中产生快速 > 3 log 病毒载量降低在基因型 1a HCV 感染患者中给药。39已被证明是安全有效的，当与具有互补机制的直接作用抗病毒药物联合使用时，SVR12 率高达 100%。