Influence of Treatment Schedule and Viral Challenge Dose on the in Vivo Influenza Virus-Inhibitory Effects of the Orally Administered Neuraminidase Inhibitor GS 4104

Experiments were done to determine how an alteration of the treatment schedule of 5 or 32 mg/kg/day per os (p.o.) doses of GS 4104 [the ethyl ester prodrug of the neuraminidase inhibitor (3R, 4R,5S)-4-acetamido-5-amino-3-(1-ethylpropoxy)-1-cylohexene-1-carboxylic acid (GS 4071)] would affect influen...

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Published inAntiviral chemistry & chemotherapy Vol. 10; no. 4; pp. 187 - 193
Main Authors Sidwell, Robert W, Bailey, Kevin W, Bemis, Paul A, Wong, Min-Hui, Eisenberg, Eugene J, Huffman, John H
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.07.1999
International Medical Press
Sage Publications Ltd
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Summary:Experiments were done to determine how an alteration of the treatment schedule of 5 or 32 mg/kg/day per os (p.o.) doses of GS 4104 [the ethyl ester prodrug of the neuraminidase inhibitor (3R, 4R,5S)-4-acetamido-5-amino-3-(1-ethylpropoxy)-1-cylohexene-1-carboxylic acid (GS 4071)] would affect influenza A (H1N1) virus infection in mice. Treatments with a low dose, one, two, three or four times daily, were highly inhibitory, unless therapy was terminated relatively early in the infection (days 2–3), in which case efficacy was curtailed. Single administrations at various times relative to virus exposure had essentially no effect. The 32 mg/kg/day dose was significantly inhibitory using all treatment schedules. These data indicated a requirement for the compound to be in the host when lung virus titres were reaching maximal levels and, for minimally effective doses, that at least continued daily therapy was needed to maintain adequate serum levels to achieve an appropriate antiviral effect. Twice daily p.o. treatment for 5 days with 20 mg/kg/day of GS 4104 totally prevented deaths in mice receiving high viral challenge doses that were sufficient to kill placebo-treated controls in less than 5 days. Other parameters of antiviral efficacy (lung consolidation, arterial oxygen saturation, lung virus titres) were also markedly inhibited regardless of viral challenge doses. These data provide further insights into how the maximum therapeutic benefit can be derived from use of this orally effective influenza virus neuraminidase inhibitor.
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ISSN:2040-2066
0956-3202
2040-2066
DOI:10.1177/095632029901000403