Peramivir: A Novel Intravenous Neuraminidase Inhibitor for Treatment of Acute Influenza Infections

Abstract

Peramivir is a novel cyclopentane neuraminidase inhibitor of influenza virus. It was approved by the Food and Drug Administration in December 2014 for treatment of acute uncomplicated influenza in patients 18 years and older. For several months prior to approval, the drug was made clinically available under Emergency Use authorization during the 2009 H1N1 influenza pandemic. Peramivir is highly effective against human influenza A and B isolates as well as emerging influenza virus strains with pandemic potential. Clinical trials demonstrated that the drug is well-tolerated in adult and pediatric populations. Adverse events are generally mild to moderate and similar in frequency to patients receiving placebo. Common side effects include gastrointestinal disorders and decreased neutrophil counts but are self-limiting. Peramivir is administered as a single-dose via the intravenous route providing a valuable therapeutic alternative for critically ill patients or those unable to tolerate other administration routes. Successful clinical trials and post-marketing data in pediatric populations in Japan support the safety and efficacy of peramivir in this population where administration of other antivirals might not be feasible.

The Cranberry Extract Oximacro® Exerts in vitro Virucidal Activity Against Influenza Virus by Interfering With Hemagglutinin

“…Despite these drugs’ efficacy against both IAV and IBV, the number of circulating NAI-resistant viruses has greatly increased in the past few years ( McKimm-Breschkin, 2005 , 2013 ). More recently, peramivir, and laninamivir octanoate have been approved as novel NAIs for the treatment of influenza, and proposed for a combined therapy regimen to prevent resistance occurrence ( Ikematsu and Kawai, 2011 ; Alame et al, 2016 ). Nevertheless, several strains that are resistant to both of these new NAIs already have been isolated ( Takashita et al, 2016 ).…”

Combined effect of anti‐high‐mobility group box‐1 monoclonal antibody and peramivir against influenza A virus‐induced pneumonia in mice

“…In severe influenza cases that cannot be treated with NAI alone, combination treatment with an anti‐HMGB1 mAb represents an interesting treatment option. In the present study, a severe influenza murine model was developed and the combined effect of an anti‐HMGB1 mAb and peramivir (intravenous NAI) treatment was examined. Furthermore, the role of the anti‐HMGB1 mAb in the translocation of HMGB1 from type I alveolar epithelial cells (AECI) was investigated.…”

Verdinexor Targeting of CRM1 is a Promising Therapeutic Approach against RSV and Influenza Viruses

“…Additional NA inhibitors have been developed that offer advantages over oseltamivir and zanamivir. Newly licensed Peramivir is now available in the US and utilizes an intravenous administration route, producing the same level of inhibition as compared to oseltamivir (oral) and zanamivir (inhalation) at lower dose concentrations [ 66 , 67 , 68 ]. Laninamivir, which is currently in phase III clinical trials, demonstrates long-acting inhibition when given as a single daily administration, whereas oseltamivir and zanamivir require twice daily dosing to be effective against influenza [ 69 , 70 , 71 , 72 , 73 , 74 ].…”