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[Influenza: new therapeutic perspectives]
1Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Abstract:
TWO WELL-KNOWN AGENTS: Although the activity of amantadin and rimantadin against type A Myxovirus influenzae are well known, use is still limited. These agents only have a moderate curative effect and, though they are more effective for prophylaxis, can only be used in cases with a certain positive diagnosis, which is difficult to obtain. In addition, questions remain concerning tolerance which is not always excellent, particularly for amantadin.
Zanamivir:
This compound belongs to a new class. It specifically inhibits the neuraminidase in type A and B Myxovirus influenzae. Given by the nasal route, zanamivir has been shown to be effective compared with placebo, reducing the duration and intensity of flu symptoms and with a very satisfactory tolerance profile. GS4104: Studies are in the preliminary phases for this agent which is a powerful inhibitor of the influenzae A and B virus neuraminidase. It has been found to be active in mouse and rodent models.
In Clinical Practice:
Vaccination remains the only effective tool today. These new compounds can only be seen as complementary agents to be used in combination with vaccination regimes.
Insights
Amantadine and rimantadine show limited effectiveness for influenza A treatment. New neuraminidase inhibitors like zanamivir offer better tolerance and symptom relief, but vaccination remains the primary prevention strategy.
Area of Science:
- Virology
- Pharmacology
Context:
- Amantadine and rimantadine are known agents against influenza A virus, but their clinical use is limited due to moderate efficacy and tolerance issues.
- Diagnosis of influenza A can be challenging, further restricting the prophylactic use of these agents.
Purpose:
- To review the efficacy and limitations of existing influenza antiviral agents and introduce novel compounds.
- To evaluate new neuraminidase inhibitors for influenza treatment and prophylaxis.
Summary:
- Amantadine and rimantadine have limited curative and prophylactic effects against influenza A, with variable tolerance.
- Zanamivir, a neuraminidase inhibitor, is effective when administered nasally, reducing flu symptom duration and intensity with good tolerance.
- GS4104, another neuraminidase inhibitor, shows promise in preclinical studies for influenza A and B.
Impact:
- Vaccination remains the most effective influenza prevention method.
- New antiviral compounds like zanamivir and GS4104 are considered complementary to vaccination strategies.
- Further research into neuraminidase inhibitors may lead to improved influenza management options.