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Peramivir protects mice from lethal H5N1 infection

sharon sanders

Editor-in-Chief & President
Peramivir protects mice from lethal H5N1 infection

Memphis, Tennessee, May 1, 2007

The antiviral drug peramivir might offer humans significant protection during a pandemic of the avian influenza virus H5N1, according to results of mouse studies conducted by investigators at St. Jude Children's Research Hospital.
Peramivir, an antiviral drug, blocks the ability of influenza viruses to use an enzyme called neuraminidase, thus preventing the release of new virus particles and their spread from one infected cell to another.
The St. Jude team studied different approaches to treating infected mice according to duration of administration (one day versus eight days); route of administration of peramivir (intramuscular injections alone versus intramuscular injections followed by oral administration) and frequency of administration on the first day of treatment (once versus twice). In all cases, the investigators administered peramivir to mice one hour after nasally administering a lethal Vietnam strain of H5N1 influenza virus.
The researchers reported 100 percent survival among 10 infected mice given intramuscular injections of peramivir daily for eight days. The drug also inhibited replication of the deadly strain of H5N1 virus in the lung, brain and spleen. The key to the high survival rate was treating the infected mice within 24 hours after infection with H5N1 and continuing the treatment for eight days. In contrast, a single intramuscular injection resulted in a 40 percent survival rate, while two intramuscular injections increased the rate to 60 percent. The single intramuscular injection did not completely inhibit H5N1 virus replication in the lungs and spleen, but did decrease the spread of virus to the brain.
?Peramivir should be given as soon as H5N1 infection is suspected, since onset of symptoms in infected humans can be delayed,? said David A. Boltz, Ph.D., a postdoctoral fellow in the laboratory of Robert G. Webster in the Infectious Diseases department at St. Jude. ?The drug could also be given as a preventive measure during an outbreak to decrease the risk of infection,? he said. Boltz is first author of the paper that was presented April 30 at the 20th International Conference on Antiviral Research in Palm Springs, Calif.
?We were surprised to see a 40 percent survival rate among mice after just a single dose of peramivir,? said Elena A. Govorkova, Ph.D., a scientific manager in the Infectious Diseases department at St. Jude. Govorkova is the paper?s senior author.
?Our findings support the use of peramivir during a pandemic, and we are currently studying the emergence of H5N1 variants that are resistant to this drug and may occur in the course of treatment,? said Natalia A. Ilyushina, Ph.D., a postdoctoral fellow in Webster?s laboratory. Ilyushina is a co-author of the paper.
Other authors of this report include Robert G. Webster (St. Jude) and C. Shane Arnold and Y. Sudhakar Babu (BioCryst Pharmaceuticals Inc., Birmingham, Ala.).
This study was supported by National Institute of Allergy and Infectious Diseases, the U.S. Public Health Service, BioCryst Pharmaceuticals and ALSAC.
St. Jude Children's Research Hospital
St. Jude Children's Research Hospital is internationally recognized for its pioneering work in finding cures and saving children with cancer and other catastrophic diseases. Founded by late entertainer Danny Thomas and based in Memphis, Tenn., St. Jude freely shares its discoveries with scientific and medical communities around the world. No family ever pays for treatments not covered by insurance, and families without insurance are never asked to pay. St. Jude is financially supported by ALSAC, its fundraising organization.

http://www.stjude.org/search/0,2616,582_3161_23020,00.html
 
Re: Peramivir protects mice from lethal H5N1 infection

Excellent news, thanks! We need all the weapons we can get.
 
Re: Peramivir protects mice from lethal H5N1 infection

If St. Jude says it saves mice, it saves mice. I will see if I can get any additional info from my sources there.
 
Re: Peramivir protects mice from lethal H5N1 infection

Peramivir has not faired well as a drug against influenza when taken orally, but does better when injected into muscle, thus the new interest being shown by HHS. So, to be effective once the pandemic hits, not only will there need to be lots of this medication on hand, but also qualified personnel standing around to innoculate the long lines of people interested. Until then, be ready to pop your Tamiflu tablets.
 
Re: Peramivir protects mice from lethal H5N1 infection

<dl class="AbstractPlusReport"><dt class="head">http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
</dt><dt class="head">
</dt><dt class="head">1: Virology. 2008 Jan 28 [Epub ahead of print]javascript:PopUpMenu2_Set(Menu18234269);
</dt><dd class="abstract"> Injectable peramivir mitigates disease and promotes survival in ferrets and mice infected with the highly virulent influenza virus, A/Vietnam/1203/04 (H5N1).

<!--AuthorList-->Yun NE, Linde NS, Zacks MA, Barr IG, Hurt AC, Smith JN, Dziuba N, Holbrook MR, Zhang L, Kilpatrick JM, Arnold CS, Paessler S.
Center for Biodefense and Emerging Infectious Diseases, Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.
The post-exposure therapeutic efficacy of injectable peramivir against highly pathogenic avian influenza type A H5N1 was evaluated in mice and in ferrets. Seventy to eighty percent of the H5N1-infected peramivir-treated mice, and 70% in the oseltamivir treated mice survived the 15-day study period, as compared to 36% in control (vehicle) group. Ferrets were infected intranasally with H5N1 followed by treatment with multiple doses of peramivir. In two of three trials, a statistically significant increase in survival over a 16-18 day period resulted from peramivir treatment, with improved survival of 40-64% in comparison to mock-treated or untreated animals. Injected peramivir mitigates virus-induced disease, reduces infectious virus titers in the lungs and brains and promotes survival in ferrets infected intranasally with this highly neurovirulent isolate. A single intramuscular peramivir injection protected mice against severe disease outcomes following infection with highly pathogenic avian influenza and multi-dose treatment was efficacious in ferrets.
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Re: Peramivir protects mice from lethal H5N1 infection

BioCryst's peramivir flunks trial
September 20, 2007
Tags Phase III Phase II flu vaccine Avian Flu Biocryst Peramivir Jon P. Stonehouse
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Blaming a flawed trial design, BioCryst Pharmaceuticals has reported its seasonal and avian flu vaccine peramivir failed a Phase II trial. Although the 313 subjects receiving single doses of peramivir showed improvement over a placebo, the results were not statistically significant. BioCryst believes that due to the introduction of a shorter injection needle in the Phase II trial compared to the Phase I trial, only one-third of subjects received an adequate intramuscular injection.

"We are clearly disappointed that we did not achieve the primary endpoint across the entire study population...Based on these results, we have a clear and concise plan to correct the issues identified in this study and continue our preparations to initiate our Phase III program by year end," said Jon P. Stonehouse, President and CEO of BioCryst Pharmaceuticals. The U.S. government funded the trial and extended a $102.6 million contract to BioCryst to develop the drug.

- see BioCryst's release for more

http://www.fiercebiotech.com/story/biocrysts-peramivir-flunks-trial/2007-09-20
 
Re: Peramivir protects mice from lethal H5N1 infection

Thanks for the post IWonder: Not good news.
As the world has all its eggs in the rickety Tamiflu basket and an inhaler based backup is not ideal for a respiratory disease it was these phase II trials went well. We need a plan B and this was the prime candidate.
 
Re: Peramivir protects mice from lethal H5N1 infection

I read that in the people who did get the injection deep enough, the results were better than anticipated. They also decided to re-examine their dosage amounts. So all is not lost; maybe even some improvements coming.
 
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