New drugs and treatment for respiratory syncytial virus

Abstract

The respiratory syncytial virus (RSV) is a global health problem affecting infants and the elderly and claiming more lives than AIDS in many parts of the world. Only two antibody drugs are approved for its prevention, and ribavarin, a relatively nonspecific antiviral, is used for treatment. In the mid-1990s, a number of pharmaceutical and biotech companies initiated research programs against RSV. Together, the academic and the industrial R&D covered the whole spectrum of antibodies, vaccines, synthetic small molecule antiviral and antisense technology, and at one point, accounted for at least 25 active R&D programs. However, coincident to the marketing of the monoclonal antibody palivizumab (Synagis) in 1998, a sharp decline in such projects ensued. Many companies recently cancelled RSV projects during a prioritisation of their R&D portfolios although the continuing medical need, large market size and sales projections clearly indicate that a safe and effective RSV drug or vaccine is likely to attain blockbuster status. Today RSV receives an insignificant fraction of the R&D budget compared with AIDS, for example. This article reviews the present status of the anti-RSV regimen, covers drugs in the market and in development, and attempts to link basic research to industrial drug development, animal models of RSV, clinical trials, current clinical management, and present and future market projections. It is hoped that the unmet medical need of the victims of RSV will encourage continued involvement of the pharmaceutical and biotechnology industry in developing safe and effective prevention and treatments for RSV.

Respiratory syncytial virus infections: characteristics and treatment

“…This claims to be 20 times more active than palivizumab in reducing viral loads in cell cultures in cotton rats (Maggon & Barik 2004).…”

“…In 1998, palivizumab received approval in the USA for the prevention of serious lower respiratory infection by RSV and it is the current market leader in RSV therapy, with annual sales of $849 million in 2003 (Maggon & Barik 2004). Monthly intramuscular injections (15 mg kg À1 ) are administered seasonally and confer passive immunity to those most susceptible to infection and most vulnerable to its serious and potentially fatal effects (Black 2003).…”

“…Palivizumab is more convenient, since it can be administered by intramuscular injection rather than by intravenous infusion (as for RSV-IGIV), which interferes with the measles-mumps-rubella vaccine and the lack of complications associated with intravenous administration of human immune globulin products. Palivizumab has also been shown to be 50-100 times more potent than RSV-IGIV and its use is approved in 50 countries (Maggon & Barik 2004).…”

“…Thirdly, an effective RSV vaccine needs to provide protection against multiple antigenic strains of RSV in the two major groups A and B. Despite these early experiences, a wide variety of approaches to production of an RSV vaccine are being considered, including both live and subunit vaccines, which are rapidly progressing (Maggon & Barik 2004). In the past 20 years of RSV vaccinology, two main types of vaccines have been formulated -live attenuated virus and subunit vaccines.…”

Esterification of the Free Carboxylic Group in 3,4-di-O-caffeoylquinic Acid Enhances the Inhibition Activity against Respiratory Syncytial Virus (RSV)

“…Many efforts have been carried on to find the effective treatment or prevention of RSV infections [10][11][12][13]. However, currently, the treatment of RSV infection is limited to administration of the nucleoside analogue ribavirin (Figure 1), a teratogen with an enigmatic mode of action that is frequently administered as an aerosol, which is very long and inconvenient regimen required for its delivery [14].…”