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Investigational Antiviral Drugs
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
John Mills, Suzanne M. Crowe, Marianne Martinello
Laninamivir is an investigational neuraminidase inhibitor being developed for treatment or prevention of influenza virus A or B infection. Multiple phase 3 clinical trials have been completed but no data are available as of July 2016. (Kashiwagi et al., 2016; Ikematsu et al., 2015; see Chapter 266, Zanamivir, laninamivir, and polymeric zanamivir conjugates).
Human Influenza Virus Infections
Published in Sunit K. Singh, Human Respiratory Viral Infections, 2014
Judith M. Fontana, Daniel P. Eiras, Mirella Salvatore
Laninamivir is a new, long-acting, inhaled NAI that is active against influenza A and B viruses. Laninamivir has been approved for use in Japan, and is currently in phase III clinical trials in the United States.247 Its structure is similar to that of zanamivir, with the exception of a methyl substitution for hydrogen in one side chain (laninamivr is 7-O-methylated zanamivir), and it therefore shares the same antiviral spectrum.248 Laninamivir is only available for inhalation because it has a very short half-life when administered intravenously. It is administered as the prodrug, laninamivir octanoate, which is rapidly metabolized to laninamivir in the lung, where it persists for days at therapeutic levels. Owing to these pharmacologic characteristics, one inhalation of laninamivir is as effective as repeated doses of oseltamivir or zanamivir, and is enough to inhibit influenza virus replication for 5 days.247 When administered either therapeutically or prophylactically in an animal model for influenza, laninamivir was active against A(H1N1)pdm09, H5N1, oseltamivir-resistant and -sensitive seasonal H1N1, and influenza B virus.249 These studies have been confirmed by preliminary randomized clinical trials in humans with oseltamivir-sensitive and oseltamivir-resistant strains of influenza virus.250,251
The use of antiviral drugs in children
Published in Journal of Chemotherapy, 2022
Marco Antonio Motisi, Agnese Tamborino, Sara Parigi, Luisa Galli, Maurizio de Martino, Elena Chiappini
Neuraminidase promotes the release of the virion from the infected host cell. Neuraminidase inhibitors are active against influenza type A and B viruses. Zanamivir is approved by the EMA for inhalation by children over the age of five. The dose is similar to that indicated for adults: two 5 mg inhalations twice daily for five days. Oseltamivir is approved by the EMA from birth age, administered twice daily for five days. Both drugs are also approved for post-exposure prevention. A systematic review involving 74 studies carried out in 2012 showed a reduction in the duration of influenza symptoms, complication rates and mortality with zanamivir and oseltamivir [10]. This success and the presence of viral strains with neuraminidase mutations that may affect their binding to oseltamivir led to the subsequent development of two more drugs in this class: peramivir, which can be administered intravenously in a single dose and is approved by the EMA for treatment in children over the age of two but not for post-exposure prophylaxis, and laninamavir, which has been approved in Japan for use in adults and children since 2010 and can be administered by inhalation in a single dose. Laninamivir has also proven effective against oseltamivir-resistant virus strains in adults [11]. It is used by inhalation as a single dose (40 mg over the age of ten and 20 mg under the age of ten), and is also approved in Japan for post-exposure prophylaxis.
Cost-effectiveness of baloxavir marboxil compared with laninamivir for the treatment of influenza in patients at high risk for complications in Japan
Published in Current Medical Research and Opinion, 2021
Mariia Dronova, Hidetoshi Ikeoka, Naoya Itsumura, Nobuo Hirotsu, Amir Ansaripour, Samuel Aballéa, Yoshie Onishi, Mark Hill, Ataru Igarashi
For the purpose of the cost-effectiveness analysis in the Japanese setting, the choice of the comparator for baloxavir was performed in line with the official guideline for economic evaluations in Japan10,11. It is recommended to select the comparator from technologies which are expected to be replaced by the evaluated technology. Among them, technologies which are widely used in clinical practice and which result in a better outcome should be selected. It is unclear, to date, which of the neuraminidase inhibitors performs better. However, according to reports of the Ministry of Health, Labour and Welfare of Japan (MHLW), laninamivir was the most often prescribed anti-influenza drug for adolescents and adults in Japan in the 2015/2016 to 2017/2018 influenza seasons (before the launch of baloxavir)12,13. Baloxavir became the most used antiviral in the following season (2018/2019), when laninamivir had the second largest market.5 It should be also noted that laninamivir was considered as the price comparator for baloxavir14. Therefore, laninamivir was chosen as an appropriate comparator for baloxavir.
Estimation of the value of convenience in taking influenza antivirals in Japanese adult patients between baloxavir marboxil and neuraminidase inhibitors using a conjoint analysis
Published in Journal of Medical Economics, 2021
Naoki Hosogaya, Takahiro Takazono, Akira Yokomasu, Shinzo Hiroi, Hidetoshi Ikeoka, Kosuke Iwasaki, Tomomi Takeshima, Hiroshi Mukae
There are two classes of antivirals available for influenza A and influenza B. One is neuraminidase inhibitors (NAIs), such as oseltamivir, zanamivir, peramivir, and laninamivir; these inhibit the release of new virus from the cell surface. The other is the cap-dependent endonuclease inhibitor baloxavir, which inhibits the initiation of viral mRNA synthesis. Among the series of antivirals, there are various dosage forms for administration. Oral oseltamivir and inhaled zanamivir are required twice daily for 5 consecutive days, and adherence – which is an important factor of successful therapy – could influence the success of treatment9. Peramivir can be used intravenously once daily or repeated administration. Laninamivir and baloxavir are both single dose antivirals; the former is inhaled, and the latter taken orally.