A Comprehensive Review of Anti-Influenza Therapeutics

Abstract

Influenza viruses cause significant global morbidity and mortality. Currently approved anti-influenza drugs include adamantanes, neuraminidase inhibitors and polymerase inhibitors that target different stages of viral life cycle. Adamantanes such as rimantadine and amantadine inhibit the viral M2 ion channel protein. Oseltamivir, zanamivir, peramivir and laninamivir are neuraminidase inhibitors that bind and block the enzymatic activity of neuraminidase. Baloxavir marboxil and favipiravir areCap-dependent endonuclease and RNA polymerase inhibitors respectively. These drugs are commonly quantified using chromatographic and spectrophotometric methods. Moreover, newer drugs such as verdinexor inhibiting viral mRNA export and ASN2 targeting cap-snatching endonuclease are under development. Advances have been made in delivery using nanoparticles, pulmonary and intranasal routes. Point-of-care molecular diagnostics aid rapid diagnosis. However, drug resistance and adverse effects persist as challenges. Future directions involve host-targeting drugs, vaccines inducing broad immunity and resistance-proof formulations. This review discusses about the approved and emerging anti-influenza therapies with analytical and delivery aspects along with ongoing efforts to address existing limitations.