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.
Highlights
Influenza virus infections cause significant morbidity and mortality during annual outbreaks and result in large economic losses due to healthcare costs and loss of productivity (Nicholson et al, 2003)
Influenza viruses belong to the Orthomyxoviridae family with two types, A and B, which are the cause of major outbreaks in humans
Elucidation of the structure and mechanism of action of the NA have made structure- and mechanism-based design of neuraminidase inhibitors (NAIs) possible (Colman, 1994; Stoll et al, 2003; von Itzstein, 2007). These data have led to the identification of several potent NA inhibitors including three that have been approved for clinical use [peramivir (Babu et al, 2000), oseltamivir (Kim et al, 1997), and zanamivir] and one that is still under development [laninamivir (Yamashita et al, 2009), currently only approved in Japan; Table 1]
Summary
Influenza virus infections cause significant morbidity and mortality during annual outbreaks and result in large economic losses due to healthcare costs and loss of productivity (Nicholson et al, 2003). These outbreaks occur during the winter season in countries with temperate weather and during rainy seasons in tropical countries (Tamerius et al, 2010). Influenza pandemics periodically occur due to the emergence of antigenically novel influenza viruses in humans and can pose a threat for higher morbidity and mortality rates than seasonal outbreaks (Salomon and Webster, 2009). Several avian-origin influenza strains carry pandemic potential (Abdelwhab and Hafez, 2011; Tan et al, 2015). Influenza control efforts have focused on vaccines and antiviral therapies that target different components of the virus or host factors
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