Efficacy and Safety of Intravenous Peramivir for Treatment of Seasonal Influenza Virus Infection

Abstract

Peramivir, a sialic acid analogue, is a selective inhibitor of neuraminidases produced by influenza A and B viruses. We evaluated the efficacy and safety of a single intravenous dose of peramivir in outpatients with uncomplicated seasonal influenza virus infection. A total of 300 previously healthy adult subjects aged 20 to 64 years with a positive influenza virus rapid antigen test were recruited within 48 h of the onset of influenza symptoms and randomized to three groups: single intravenous infusion of either 300 mg peramivir per kg of body weight, 600 mg peramivir, or matching placebo on study day 1. Influenza symptoms and body temperature were self-assessed for 14 days. Nasal and pharyngeal swabs were collected to determine the viral titer. The primary endpoint was the time to alleviation of symptoms. Of the 300 subjects, 296 were included in the intent-to-treat infected population (300 mg peramivir, n ‫؍‬ 99; 600 mg peramivir, n ‫؍‬ 97; and placebo, n ‫؍‬ 100). Peramivir significantly reduced the time to alleviation of symptoms at both 300 mg (hazard ratio, 0.681) and 600 mg (hazard ratio, 0.666) compared with placebo (adjusted P value, 0.0092 for both comparisons). No serious adverse events were reported. Peramivir was well tolerated, and its adverse-event profile was similar to that of placebo. A single intravenous dose of peramivir is effective and well tolerated in subjects with uncomplicated seasonal influenza virus infection.

The Neuraminidase Inhibitor Peramivir Ameliorates Myocarditis Induced by Influenza A (H1n1pdm) Virus in a Murine Model

“…It was reported that peramivir increased survival rate of animals infected with lethal dose of influenza virus by the pharmaceutical company of peramivir, and its in vitro activity has been demonstrated to be comparable to or better than that of oseltamivir carboxylate and zanamivir [17,28]. Peramivir has been approved in Japan for the treatment of general seasonal influenza in adults, as a single dose of 300 mg intravenously [18,21]. A single dose or multiple daily doses of 600 mg of peramivir are administered intravenously depending on the condition of the patient.…”

“…Peramivir is a selective inhibitor of influenza neuraminidase that is effective when administrated intramuscularly and intravenously for the treatment of influenza virus infection in mouse models [17][18][19][20]23]. To analyze the effects of peramivir on influenza A (H1N1pdm) virus myocarditis, we investigated survival rates, cardiac function, histological findings and cytokine induction in murine influenza A (H1N1pdm) virus -induced myocarditis.…”

“…The neuraminidase inhibitors represent an important advance in the treatment of influenza [17][18][19][20][21][22][23][24]. Treatment with neuraminidase inhibitors is also recommended by the Japanese association of Infection for all patients infected with influenza [25,26].…”

In-silico structural analysis of the influenza A subtype H7N9 neuraminidase and molecular docking with different neuraminidase inhibitors

“…Meanwhile, laninamivir is another long-acting NA inhibitor including oseltamivir-resistant viruses in adults [24,25]. Recently, peramivir has been approved in Japan for use in over 1 month of age [11].…”

Mathematical Model of Seasonal Influenza Epidemic in Central Java With Treatment Action

“…This virus infects poultries and mammals. The common symptoms of this disease include headache, aches or pains in muscles or joints, feverishness, fatigue, cough, sore throat, and nasal congestion (see [9]). Children also may develop croup or bronchiolitis.…”