Table 2.
Antiviral therapy in the pipeline for treatment and prophylaxis of common respiratory viral infections.
| Viral infection | Antiviral agent | Mechanism of action | Phase of development, p population |
|---|---|---|---|
| Influenza virus | DAS181 (Ansun BioPharma, San Diego, CA, USA) | Recombinant fusion protein that binds to cells and efficiently removes cell-surface sialic acid residues from respiratory epithelium, inhibiting viral infection | Phase II clinical trials in immunocompromised subjects |
| Favipiravir (T705; Toyama Chemical, Tokyo, Japan) | Nucleotide analog and inhibitor of the viral RNA polymerase of influenza | Phase III clinical trials. Uncomplicated influenza in adults | |
| Laninamivir (CS-8958; Biota | Long-acting NAI | Phase III clinical trials in children and adults | |
| JNJ-63623872 (VX-787; Janssen Pharma, Titusville, USA) | Nonnucleoside inhibitor targeting PB2, an influenza RNA polymerase protein | Phase I clinical trials, and a Phase II trial in combination with oseltamivir in adults and elderly hospitalized patients | |
| Nitazoxanide (NT-300; Romark Laboratories, Florida, USA) | Inhibits the maturation of influenza virus HA | Phase III clinical trial | |
| MEDI8852 (AstraZeneca, Gaithersburg, Maryland, USA) | Monoclonal antibody targeting the highly conserved epitope in the HA stalk of influenza A virus | Phase IIa in adults with uncomplicated influenza, and phase IIb in adults hospitalized with influenza A | |
| VIS410 (Visterra, Inc., Cambridge, MA, USA) | Anti-HA antibody, which bind to a conserved region of the HA stalk of the influenza virus | Phase IIa clinical trial in healthy subjects | |
| Respiratory syncytial virus | ALN-RSV01 (Alnylam Pharmaceuticals, Cambridge, MA, USA) | Small-interfering RNA (siRNA) that inhibits RSV replication by interrupting synthesis of the viral nucleocapsid protein | Phase II clinical trial in Lung transplant |
| RI-001(ADMA Biologics, Inc., Hackensack, NJ, USA) | Polyclonal high-titers RSV immunoglobulin | Phase II in immunocompromised patients | |
| MDT-637 (MicroDose Therapeutx, Monmouth Junction, NJ, USA; Gilead Sciences, Foster City, CA, USA) | Antiviral fusion inhibitors | Phase I clinical trial in healthy adults | |
| GS-5806 (Gilead Sciences, Foster City, CA, USA) | Antiviral fusion inhibitors | Phase IIb in hematopoietic stem cell transplant | |
| AL-8176 (Alios, South San Francisco, CA, USA) | Nucleoside inhibitor of the L-protein | Phase II in adults 60 years old and older | |
| Parainfluenza virus | DAS181 (Ansun BioPharma, San Diego, CA, USA) | Sialidase fusion protein effectively cleaves sialic acid from respiratory epithelial cells, preventing viral entry into the cells | Phase II in immunocompromised subjects with lower tract respiratory infection |
| BCX2798 and BCX2855 (BioCryst Pharmaceuticals, Inc., Birmingham, AL, USA) | Combined hemagglutinin neuraminidase inhibitor | In vitro and mice studies | |
| Human rhinovirus | Vapendavir (Aviragen Therapeutics, Alpharetta, GA, USA) | Binds to the HRV VP1 capsid protein and prevents the release of viral RNA into the target cells | Phase II in asthmatic adults |
| Human Metapneumovirus | MAb 338 (Medimmune, Gaithersburg, MD, USA) | Target HMPV fusion proteins | Invitro. No clinical trials |
| Human Fab DS7 | Human monoclonal antibody fragment with biological activity against the fusion protein | Invitro. No clinical trials |
NAI: neuraminidase inhibitors
HA: hemagglutinin