Peramivir: an intravenous neuraminidase inhibitor

Abstract

Introduction: Peramivir (BCX-1812, RWJ-270201) is a highly selective inhibitor of influenza A and B neuraminidase that has recently been approved in the USA by the FDA to treat acute, uncomplicated influenza in adults.

Areas covered: This review examines the discovery and development of peramavir as well as its role in the treatment of influenza. Peramivir is currently the only FDA-approved anti-influenza agent that can be given as an intravenous injection, granting it a unique role in therapy with the potential to improve adherence and outcomes in patients who are unable to tolerate oral agents. In vitro, animal, human and safety data are presented as well as information regarding special populations, resistance and drug approval.

Expert opinion: Clinical trial data support the use of peramivir to relieve influenza symptoms in acute, uncomplicated influenza, with improvements over placebo similar to those of other approved anti-influenza treatments. The ability to give a one-time injectable dose offers improved adherence over currently available oral regimens. While not approved for hospitalized patients, available data suggest that multiple dose peramivir may also have a role in treatment of severally ill, hospitalized patients. Supportive data for the use of peramivir in special patient populations such as pediatrics and those especially at-risk to develop severe influenza symptoms are promising; however, they require further study.

Keywords:

• influenza
• neuraminidase inhibitor
• oseltamivir
• peramivir
• zanamivir

Declaration of interests

MM McLaughlin has served on an advisory board for BioCryst Pharmaceuticals. MG Ison has received research support, paid to Northwestern University, from Anolinx, BioCryst, Chimerix, Gilead, GlaxoSmithKline and ViroPharma; he is a paid consultant for Biota, Chimerix and Genentech/Roche; he is a paid member of a Data and Safety Monitoring Board for Abbott and Vertex; he is an unpaid consultant to Adamas, BioCryst, Cellex, Clarassance, GlaxoSmithKline, GenMarkDx, Romark, Toyama/MediVector, NexBio, Theraclone and Vertex. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.