Treating influenza with neuraminidase inhibitors: an update of the literature

ABSTRACT

Introduction

Influenza affects individuals of all ages and poses a significant threat during pandemics, epidemics, and sporadic outbreaks. Neuraminidase inhibitors (NAIs) are currently the first choice in the treatment and prevention of influenza, but their use can be hindered by viral resistance.

Areas covered

This review summarizes current NAIs pharmacological profiles, their current place in therapy, and the mechanisms of viral resistance and outlines possible new indications, ways of administration, and novel candidate NAIs compounds.

Expert opinion

NAIs represent a versatile group of compounds with diverse administration methods and pharmacokinetics. While the prevalence of influenza virus resistance to NAIs remains low, there is heightened vigilance due to the pandemic potential of influenza. Several novel NAIs and derivatives are currently under assessment at various stages of development for the treatment and prevention of influenza.

KEYWORDS:

• NAIs
• influenza A
• influenza B
• oseltamivir
• peramivir
• zanamivir
• laninamivir
• baloxavir

Article highlights

• NAIs are the current recommended compounds for influenza treatment and prophylaxis

• Owing to the risk of changes in NAIs susceptibility, novel strategies in the management of influenza are warranted

• Improved and new formulations of NAIs and combination treatment with other compounds active against influenza are being explored to preserve NAIs efficacy

• Research on novel compounds targeting influenza is among the implemented strategies to improve outcome

Declaration of interest

Outside the submitted work, M Bassetti has received funding from scientific advisory boards, travel, and speaker honoraria from Cidara, Gilead, Menarini, MSD, Mundipharma, Pfizer and Shionogi. Outside the submitted work, D Roberto Giacobbe reports investigator-initiated grants from Pfizer, Shionogi, BioMérieux, and Gilead Italia, and speaker/advisor fees from Pfizer, Menarini, and Tillotts Pharma. 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.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.