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Ando Y, Noshi T, Sato K, Ishibashi T, Yoshida Y, Hasegawa T, Onishi M, Kitano M, Oka R, Kawai M, Yoshida R, Sato A, Shishido T, Naito A. Pharmacokinetic and pharmacodynamic analysis of baloxavir marboxil, a novel cap-dependent endonuclease inhibitor, in a murine model of influenza virus infection. J Antimicrob Chemother 2021; 76:189-198. [PMID: 33035324 PMCID: PMC7729387 DOI: 10.1093/jac/dkaa393] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/11/2020] [Indexed: 11/23/2022] Open
Abstract
Background Baloxavir acid, the active form of the orally available prodrug baloxavir marboxil, is a novel cap-dependent endonuclease inhibitor of influenza virus. Baloxavir marboxil has been shown to rapidly reduce virus titres compared with oseltamivir in clinical studies. Objectives We investigated the relationship between pharmacokinetic (PK) parameters and antiviral activity of baloxavir acid based on virus titre reduction in lungs of infected mice. Methods BALB/c mice infected with a sub-lethal dose of influenza A(H1N1), A(H1N1)pdm09, A(H3N2) or type B virus were treated on day 5 with oral baloxavir marboxil (0.5–50 mg/kg q12h), subcutaneous baloxavir acid (0.25–8 mg/kg/day), oseltamivir phosphate (5 or 50 eq mg/kg q12h) or other antivirals for 1 day. Lung virus titres were assessed 24 h after initial antiviral dosing. PK testing was performed at up to 24 h post-dosing of baloxavir marboxil or baloxavir acid in A/WSN/33-infected mice and the PK/pharmacodynamic (PD) relationship was evaluated for baloxavir acid. Results Oral baloxavir marboxil administration showed dose-dependent virus titre reductions in lungs of mice infected with the different types/subtypes of influenza viruses 24 h post-dosing. Baloxavir marboxil at 15 mg/kg q12h resulted in ≥100-fold and ≥10-fold reductions in influenza A and B virus titres, respectively, compared with oseltamivir phosphate. PK/PD analysis showed that the plasma concentration at the end of the dosing interval (Cτ) or the plasma concentration at 24 h after initial dosing (C24) was the PK parameter predicting the virus titres at 24 h post-dosing of baloxavir acid. Conclusions PK/PD analysis of baloxavir acid based on virus titre reduction in this mouse model could be helpful in predicting and maximizing virological outcomes in clinical settings.
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Affiliation(s)
- Yoshinori Ando
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Takeshi Noshi
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Kenji Sato
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Toru Ishibashi
- Project Management Department, Shionogi & Co., Ltd, 12F, Hankyu Terminal Bldg, 1-4, Shibata 1-chome, Kita-ku, Osaka 530-0012, Japan
| | - Yuki Yoshida
- Data Science Office, Shionogi & Co., Ltd, 12F, Hankyu Terminal Bldg, 1-4, Shibata 1-chome, Kita-ku, Osaka 530-0012, Japan
| | - Takahiro Hasegawa
- Biostatistics Center, Shionogi & Co., Ltd, 12F, Hankyu Terminal Bldg, 1-4, Shibata 1-chome, Kita-ku, Osaka 530-0012, Japan
| | - Motoyasu Onishi
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Mitsutaka Kitano
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Ryoko Oka
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Makoto Kawai
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Ryu Yoshida
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Akihiko Sato
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Takao Shishido
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Akira Naito
- Shionogi Pharmaceutical Research Center, Shionogi & Co., Ltd, 3-1-1, Futaba-cho, Toyonaka, Osaka 561-0825, Japan
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Ding H, Wu S, Dai X, Gao Y, Niu Y, Fang N, Song Y, Zhang M, Wang X, Chen T, Zhang G, Wu J, Li Y, Han J. Pharmacokinetic behavior of peramivir in the plasma and lungs of rats after trans-nasal aerosol inhalation and intravenous injection. Biomed Pharmacother 2020; 129:110464. [PMID: 32768954 DOI: 10.1016/j.biopha.2020.110464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/16/2020] [Accepted: 06/24/2020] [Indexed: 12/15/2022] Open
Abstract
Peramivir, a neuraminidase inhibitor, was approved globally and is indicated for the treatment of uncomplicated influenza in adults and children. However, the only approved intravenous formulation of peramivir limits its clinical application due to the need for the specialized dosing techniques and increases the risk of contracting influenza virus infection among healthcare professionals when dosing within a short distance to the patient. The purpose of this study was to investigate the pharmacokinetic profile of peramivir in plasma and the lung of rats and to compare the profiles following administration through trans-nasal aerosol inhalation (0.0888, 0.1776, and 0.3552 mg/kg) and intravenous injection (30 mg/kg). The plasma concentration reached the Cmax within 1.0 h (upon inhalation) and decreased at a t1/2 of 6.71 and 10.9 h after inhalation and injection, respectively. The absolute bioavailability of peramivir after inhalation was 78.2 %. Overall, the pharmacokinetic exposure of peramivir in the lungs was higher than that in the plasma after aerosol inhalation. After inhalation, the Cmax of peramivir in the lung was achieved within 1.0 h, and the elimination of the drug was slower than in the case of intravenous injection with t1/2 values 1.81 h for injection and 5.72, 53.5, and 32.1 h for low, middle, and high doses administered through inhalation. The Cmax and AUC0-t values for peramivir in the lungs increased linearly with the increased inhalation dose. The results elucidate the pharmacokinetic process of peramivir after trans-nasal aerosol inhalation to rats and provide useful information for further rational application of this drug formulation.
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Affiliation(s)
- Hao Ding
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Siyang Wu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Xianhui Dai
- Department of Respiratory Medicine, Chengyang People's Hospital, Qingdao, 266109, China
| | - Yang Gao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Ying Niu
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Na Fang
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Yang Song
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Muzihe Zhang
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Xiaoyang Wang
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Tengfei Chen
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Guangping Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jiarui Wu
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Yingfei Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Jin Han
- Department of Pharmacy, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
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Kobayashi M, Kodama M, Noshi T, Yoshida R, Kanazu T, Nomura N, Soda K, Isoda N, Okamatsu M, Sakoda Y, Yamano Y, Sato A, Kida H. Therapeutic efficacy of peramivir against H5N1 highly pathogenic avian influenza viruses harboring the neuraminidase H275Y mutation. Antiviral Res 2016; 139:41-48. [PMID: 28012921 DOI: 10.1016/j.antiviral.2016.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 11/24/2022]
Abstract
High morbidity and mortality associated with human cases of highly pathogenic avian influenza (HPAI) viruses, including H5N1 influenza virus, have been reported. The purpose of the present study was to evaluate the antiviral effects of peramivir against HPAI viruses. In neuraminidase (NA) inhibition and virus replication inhibition assays, peramivir showed strong inhibitory activity against H5N1, H7N1 and H7N7 HPAI viruses with sub-nanomolar activity in enzyme assays. In H5N1 viruses containing the NA H275Y mutation, the antiviral activity of peramivir against the variant was lower than that against the wild-type. Evaluation of the in vivo antiviral activity showed that a single intravenous treatment of peramivir (10 mg/kg) prevented lethality in mice infected with wild-type H5N1 virus and also following infection with H5N1 virus with the H275Y mutation after a 5 day administration of peramivir (30 mg/kg). Furthermore, mice injected with peramivir showed low viral titers and low levels of proinflammatory cytokines in the lungs. These results suggest that peramivir has therapeutic activity against HPAI viruses even if the virus harbors the NA H275Y mutation.
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Affiliation(s)
- Masanori Kobayashi
- Drug Discovery & Disease Research Laboratories, Shionogi & Co., Ltd., Osaka, Japan
| | - Makoto Kodama
- Drug Discovery & Disease Research Laboratories, Shionogi & Co., Ltd., Osaka, Japan
| | - Takeshi Noshi
- Drug Discovery & Disease Research Laboratories, Shionogi & Co., Ltd., Osaka, Japan
| | - Ryu Yoshida
- Drug Discovery & Disease Research Laboratories, Shionogi & Co., Ltd., Osaka, Japan
| | - Takushi Kanazu
- Research Laboratory for Development, Shionogi & Co., Ltd., Osaka, Japan
| | - Naoki Nomura
- Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan; Laboratory for Biologics Development, Research Center for Zoonosis Control, Hokkaido University, Hokkaido, Japan
| | - Kosuke Soda
- Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan; Avian Zoonosis Research Center, Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Norikazu Isoda
- Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan; Global Station for Zoonosis Control, Global Institute for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, Japan; Unit of Risk Analysis and Management, Research Center for Zoonosis Control, Hokkaido University, Hokkaido, Japan
| | - Masatoshi Okamatsu
- Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Yoshihiro Sakoda
- Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido, Japan; Global Station for Zoonosis Control, Global Institute for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, Japan
| | - Yoshinori Yamano
- Drug Discovery & Disease Research Laboratories, Shionogi & Co., Ltd., Osaka, Japan
| | - Akihiko Sato
- Drug Discovery & Disease Research Laboratories, Shionogi & Co., Ltd., Osaka, Japan; Research Center for Zoonosis Control, Hokkaido University, Hokkaido, Japan.
| | - Hiroshi Kida
- Research Center for Zoonosis Control, Hokkaido University, Hokkaido, Japan; Global Station for Zoonosis Control, Global Institute for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, Japan
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Saisho Y, Ishibashi T, Fukuyama H, Fukase H, Shimada J. Pharmacokinetics and safety of intravenous peramivir, neuraminidase inhibitor of influenza virus, in healthy Japanese subjects. Antivir Ther 2016; 22:313-323. [PMID: 27805571 DOI: 10.3851/imp3104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Intravenous peramivir is a potent neuraminidase (NA) inhibitor with activity against influenza A and B viruses. The early use of NA inhibitors has been shown to reduce mortality in influenza patients. METHODS To evaluate the pharmacokinetics of peramivir and confirm the safety and tolerability of multiple infusions of peramivir in healthy Japanese subjects, two Phase I, single-centre, randomized, double-blind and placebo-controlled studies consisting of a multiple-dose study and a high-dose study were conducted. RESULTS Multiple intravenous infusions of peramivir were well tolerated up to 800 mg once a day and 400 mg twice daily for 6 days. Dose proportionalities for maximum plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) were established up to the 800 mg dose. Approximately 90% of unchanged peramivir was excreted into urine within 12 h after treatment with 800 mg of peramivir. The peramivir plasma and upper respiratory tract fluid levels were significantly higher than the 50% inhibition concentrations for NA enzyme activity (IC50) of epidemic influenza viruses, including those harbouring the H274Y mutation. CONCLUSIONS The pharmacokinetic properties obtained here for intravenous peramivir are consistent with the previously reported clinical efficacy and safety of this antiviral.
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Affiliation(s)
- Yutaka Saisho
- Medical Affairs Department, Shionogi & Co., Ltd, Osaka, Japan
| | - Toru Ishibashi
- Clinical Research Department, Shionogi & Co., Ltd, Osaka, Japan
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Oh DY, Hurt AC. Using the Ferret as an Animal Model for Investigating Influenza Antiviral Effectiveness. Front Microbiol 2016; 7:80. [PMID: 26870031 PMCID: PMC4740393 DOI: 10.3389/fmicb.2016.00080] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/18/2016] [Indexed: 01/12/2023] Open
Abstract
The concern of the emergence of a pandemic influenza virus has sparked an increased effort toward the development and testing of novel influenza antivirals. Central to this is the animal model of influenza infection, which has played an important role in understanding treatment effectiveness and the effect of antivirals on host immune responses. Among the different animal models of influenza, ferrets can be considered the most suitable for antiviral studies as they display most of the human-like symptoms following influenza infections, they can be infected with human influenza virus without prior viral adaptation and have the ability to transmit influenza virus efficiently between one another. However, an accurate assessment of the effectiveness of an antiviral treatment in ferrets is dependent on three major experimental considerations encompassing firstly, the volume and titer of virus, and the route of viral inoculation. Secondly, the route and dose of drug administration, and lastly, the different methods used to assess clinical symptoms, viral shedding kinetics and host immune responses in the ferrets. A good understanding of these areas is necessary to achieve data that can accurately inform the human use of influenza antivirals. In this review, we discuss the current progress and the challenges faced in these three major areas when using the ferret model to measure influenza antiviral effectiveness.
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Affiliation(s)
- Ding Y Oh
- WHO Collaborating Centre for Reference and Research on Influenza, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, MelbourneVIC, Australia; School of Applied and Biomedical Sciences, Federation University Australia, GippslandVIC, Australia
| | - Aeron C Hurt
- WHO Collaborating Centre for Reference and Research on Influenza, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, MelbourneVIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, ParkvilleVIC, Australia
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