Pathways for Dolutegravir Transformation 
from a Daily Oral to a Once-a-Year Parenteral Medicine

Deodhar, Suyash; Sillman, Brady; Bade, Aditya N.; McMillan, JoEllyn M; Gautam, Nagsen; Hanson, Brandon; Shetty, Bhagya Laxmi Dyavar; Szlachetka, Adam M.; Johnston, Morgan; Thurman, Michellie; Munt, Daniel J; Dash, Alekha K.; Marković, Milica; Dahan, Arik; Alnouti, Yazen; Kevadiya, Bhavesh D.; Byrareddy, Siddappa N.; Cohen, Samuel M.; Edagwa, Benson; Gendelman, Howard E.

doi:10.21203/rs.3.rs-1255147/v1

Cited by 1 publication

(1 citation statement)

References 38 publications

(63 reference statements)

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“…Indeed, pre-exposure prophylaxis has shown its benefit in the prevention of viral acquisition in uninfected individuals engaged in high-risk behaviors 54 . Recent advances in chemical pharmacology have led to the emergence of ultra-long-acting (XLA) antiviral formulations that may provide drug exposure for several months or up to 1 year [55][56][57][58][59] . The advent of these medicines might transform the way to confront new COVID-19 surges.…”

Section: Long-acting Antiviral Formulationsmentioning

confidence: 99%

Oral antivirals for the prevention and treatment of SARS-CoV-2 infection

Soriano¹,

de-Mendoza²,

Edagwa³

et al. 2022

AIDSRev

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Vaccines and antivirals are the classical weapons deployed to contain, prevent, and treat life-threatening viral illnesses. Specifically, for SARS-CoV-2 infection, vaccines protect against severe COVID-19 disease manifestations and complications. However, waning immunity and emergence of vaccine escape mutants remains a growing threat. This is highlighted by the current surge of the omicron COVID-19 variant. Thus, there is a race to find treatment alternatives. We contend that oral small molecule antivirals that halt SARS-CoV-2 infection are essential. Compared to currently available monoclonal antibodies and remdesivir, where parenteral administration is required, oral antivirals offer treatments in an outpatient setting with dissemination available on a larger scale. In response to this need at 2021's end, regulatory agencies provided emergency use authorization for both molnupiravir and nirmatrelvir. These medicines act on the viral polymerase and protease, respectively. Each is given for 5 days and can reduce disease progression by 30% and 89%, respectively. The advent of additional oral antivirals, the assessment of combination therapies, the formulation of extended-release medications, and their benefit for both early treatment and prophylaxis will likely transform the landscape of the COVID-19 pandemic.

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