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Rani R, Long S, Pareek A, Dhaka P, Singh A, Kumar P, McInerney G, Tomar S. Multi-target direct-acting SARS-CoV-2 antivirals against the nucleotide-binding pockets of virus-specific proteins. Virology 2022; 577:1-15. [PMID: 36244310 PMCID: PMC9539459 DOI: 10.1016/j.virol.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/20/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Abstract
The nucleotide-binding pockets (NBPs) in virus-specific proteins have proven to be the most successful antiviral targets for several viral diseases. Functionally important NBPs are found in various structural and non-structural proteins of SARS-CoV-2. In this study, the first successful multi-targeting attempt to identify effective antivirals has been made against NBPs in nsp12, nsp13, nsp14, nsp15, nsp16, and nucleocapsid (N) proteins of SARS-CoV-2. A structure-based drug repurposing in silico screening approach with ADME analysis identified small molecules targeting NBPs in SARS-CoV-2 proteins. Further, isothermal titration calorimetry (ITC) experiments validated the binding of top hit molecules to the purified N-protein. Importantly, cell-based antiviral assays revealed antiviral potency for INCB28060, darglitazone, and columbianadin with EC50 values 15.71 μM, 5.36 μM, and 22.52 μM, respectively. These effective antivirals targeting multiple proteins are envisioned to direct the development of antiviral therapy against SARS-CoV-2 and its emerging variants.
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Affiliation(s)
- Ruchi Rani
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
| | - Siwen Long
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Akshay Pareek
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
| | - Preeti Dhaka
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
| | - Ankur Singh
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
| | - Pravindra Kumar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
| | - Gerald McInerney
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Shailly Tomar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India.
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Clark I, Wallman P, Cornelius V, Taylor D. Factors predicting relapse and treatment discontinuation with paliperidone 3-monthly long-acting injection: A 2-year naturalistic follow-up study. Eur Psychiatry 2021; 64:e68. [PMID: 34698007 PMCID: PMC8668450 DOI: 10.1192/j.eurpsy.2021.2243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Paliperidone 3-monthly (PP3M) long-acting injection has proven efficacy and effectiveness in schizophrenia. Little is known of its effectiveness in other diagnoses. METHODS All patients starting PP3M were followed up for 2 years. Main outcome measures were relapse and discontinuation from PP3M. Post hoc we examined outcomes in those switched back to one monthly paliperidone (PP1M) long-acting injection. RESULTS Overall, 186 patients were followed-up. At the 2-year end point, 110 patients (59%) were still receiving PP3M, and 129 (70%) were receiving some form of paliperidone long-acting injection. Discontinuation from paliperidone long-acting injections (PPLAIs) was more likely with a nonschizophrenia diagnosis (hazard ratio [HR] for continuation 0.429 [95% confidence intervals (CI) - 0.21, 0.87 p = 0.018)), and prior clozapine use [in PP3M patients; HR for discontinuation 1.87 [95% CI - 1.05, 3.30 p = 0.032]). Relapse occurred in 20 (11%) of those receiving PP3M. Relapse on PP3M and PPLAIs was more likely in nonschizophrenia diagnosis (HR 0.17 for remaining relapse-free [95% CI - 0.06, 0.50; p = 0.001]; HR 0.21 [95% CI - 0.08, 0.58 p = 0.002], respectively), polypharmacy in PP3M patients (HR for relapse 7.91 [95% CI - 3.73, 22.9; p < 0.001]) and PPLAI patients (HR for relapse 6.45 [95% CI - 2.49, 16.5; p < 0.001]), and prior clozapine use in PP3M patients (HR for relapse 6.11 [95% CI - 1.82, 20.5; p = 0.003]) and PPLAI patients (HR for relapse 4.52 (95% CI - 1.51, 13.5; p = 0.007). CONCLUSIONS Outcomes with PP3M are excellent in practice, even when used outside its formal license. PP3M was relatively more effective in those with an F20 schizophrenia diagnosis and in those never before considered for or prescribed clozapine.
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Affiliation(s)
- Ivana Clark
- Pharmacy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, LondonSE5 8AZ, UK
| | - Phoebe Wallman
- Pharmacy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, LondonSE5 8AZ, UK
| | - Victoria Cornelius
- School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, LondonW12 7RH, UK
| | - David Taylor
- Pharmacy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, LondonSE5 8AZ, UK
- Institute of Pharmaceutical Science, King’s College, 5th Floor, Franklin-Wilkins Building, 150 Stamford Street, LondonSE1 9NH, UK
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Bailly M, Queuille E, Juillard-Condat B, Paubel P. [Comparative analysis of the financing of follow-up and rehabilitation care institutions and public mental health institutions: Application for innovative and expensive drugs]. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 79:690-699. [PMID: 33713639 DOI: 10.1016/j.pharma.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
Pharmacotherapeutic care is now expanding in public mental health institutions. Annual grants are funding the public psychiatric field, hindering access to therapeutic innovation and expensive medications due to long length of stay. On the threshold of the French Healthcare & Social Services Ministry "Ma Santé 2022" plan ("My Health 2022"), there is a risk of altering the continuum of care because of the complexity of the financing of certain high added value therapies. Despite a desire to adapt the system to meet constantly changing health needs, no actions have been taken to this date in psychiatry, with no funds being allocated for valuable medication, in contrary to follow-up care and rehabilitation structures, to our knowledge. This reinforces the discrepancy with the evolution of research, and further widens the gap in inequalities between health sectors. Optimising the funding of expensive medicines in psychiatry would make it possible to reduce the stranglehold of current allocations. Following the example of recent reforms in the follow-up care and rehabilitation structures, extra funds for high value-added therapies would make it possible to reduce complex medical decisions: from prevention to reintegration, patient care continuity would be vastly guaranteed.
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Affiliation(s)
- M Bailly
- Service pharmacie, centre hospitalier spécialisé Charles-Perrens, 33076 Bordeaux, France.
| | - E Queuille
- Service pharmacie, centre hospitalier spécialisé Charles-Perrens, 33076 Bordeaux, France
| | - B Juillard-Condat
- Inserm UMR 1027, université Toulouse III, 31400 Toulouse, France; Service pharmacie, centre hospitalier universitaire de Toulouse, 31400 Toulouse, France
| | - P Paubel
- Service évaluations pharmaceutiques et bon usage, AGEPS, AP-HP, 75005 Paris, France; Faculté de pharmacie de Paris, institut droit et santé, Inserm UMR S 1145, université de Paris, 75006 Paris, France
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Girardi P, Del Casale A, Rapinesi C, Kotzalidis GD, Splendori F, Verzura C, Trovini G, Sorice S, Carrus D, Mancinelli I, Comparelli A, De Filippis S, Francomano A, Ballerini A, Marcellusi A, Mennini FS, Ducci G, Sani G, Pompili M, Brugnoli R. Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate. Hum Psychopharmacol 2018; 33:e2658. [PMID: 29766576 DOI: 10.1002/hup.2658] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/22/2018] [Accepted: 04/09/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-acting injectable (LAI) antipsychotics can improve medication adherence and reduce hospitalisation rates compared with oral treatments. Paliperidone palmitate (PAL) and aripiprazole monohydrate (ARI) LAI treatments were associated with improvements in global functioning in patients with schizophrenia. OBJECTIVE The objective of this study was to assess the predictive factors of better overall functioning in patients with chronic schizophrenia and schizoaffective disorder treated with PAL and ARI. METHOD Enrolled were 143 (97 males, 46 females, mean age 38.24 years, SD = 12.65) patients with a diagnosis of schizophrenia or schizoaffective disorder, whom we allocated in two groups (PAL and ARI treatments). We assessed global functioning, amount of oral medications, adherence to oral treatment, and number of hospitalisations before LAI introduction and at assessment time point. RESULTS Longer treatment time with LAIs (p < .001), lower number of oral drugs (p < .001), and hospitalisations (p = .002) before LAI introduction, and shorter duration of illness (p = .038) predicted better Global Assessment of Functioning scores in the whole sample (R2 = 0.337). CONCLUSION Early administration and longer duration of ARI or PAL treatments could play a significant role in improving global functioning of patients with schizophrenia and schizoaffective disorder. Better improvement in functioning could be achieved with ARI in young individuals with recent illness onset and PAL in patients at risk for recurrent hospitalisations.
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Affiliation(s)
- Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Francesca Splendori
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Claudio Verzura
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Giada Trovini
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Serena Sorice
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Dario Carrus
- Mental Health Department, Azienda Sanitaria Locale Viterbo, Viterbo, Italy
| | - Iginia Mancinelli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Anna Comparelli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | | | - Antonio Francomano
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Andrea Ballerini
- Department of Neuroscience, Psychology, Drug Research and Child Health, Section of Neuroscience, University of Florence, Florence, Italy
| | - Andrea Marcellusi
- Faculty of Economics, Centre for Economic and International Studies (CEIS)-Economic Evaluation and HTA (EEHTA), Tor Vergata University, Rome, Italy
| | - Francesco S Mennini
- Faculty of Economics, Centre for Economic and International Studies (CEIS)-Economic Evaluation and HTA (EEHTA), Tor Vergata University, Rome, Italy
| | - Giuseppe Ducci
- Mental Health Department, Azienda Sanitaria Locale Roma 1, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Rome, Italy
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Patel H, Patel P, Modi N, Patel P, Wagh Y, George A, Desai N, Srinivas NR. Rats and rabbits as pharmacokinetic screening tools for long acting intramuscular depots: case study with paliperidone palmitate suspension. Xenobiotica 2018; 49:415-421. [PMID: 29642738 DOI: 10.1080/00498254.2018.1464683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Development of prodrug of 9-hydroxyrisperidone (paliperidone) long-acting intramuscular injection has enabled delivery over four-week time period with improved compliance. The key aim of this work was to establish a reliable preclinical model which may potentially serve as a screening tool for judging the pharmacokinetics of paliperidone formulation(s) prior to human clinical work. Sparse sampling composite study was used in rats, (Wistar/Sprague-Dawley (SD; n = 10)) and a serial blood sampling study design was used in rabbits (n = 4). Animals received intramuscular injection of paliperidone palmitate in the thigh muscle at dose of 16 (rats) and 4.5 mg/kg (rabbits). Samples were drawn in rats (retro-orbital sinus) and rabbits (central ear artery) and were analysed for paliperidone using liquid chromatography-mass spectrometry/ mass spectrometry (LC-MS/MS) assay. The plasma data was subjected to pharmacokinetic analysis. Following intramuscular injection of depot formulation in Wistar/SD rats and rabbits, absorption of paliperidone was slow and gradual with median value of time to reach maximum concentration (Tmax) occurring on day 7. The exposures (i.e. area under the curve (AUC; 0-28) days) were 18,597, 21,865 and 18,120 ng.h/mL, in Wistar, SD and rabbits, respectively. The clearance was slow and supported long half-life (8-10 days). Either one of the two models can serve as a research tool for establishing pharmacokinetics of paliperidone formulation(s).
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Affiliation(s)
- Harilal Patel
- a Bioanalytical/Drug Metabolism and Pharmacokinetics Laboratory , Zydus Research Centre , Ahmedabad , India.,b Department of Chemistry , St Xavier's College (Autonomous) , Ahmedabad , India
| | - Prakash Patel
- a Bioanalytical/Drug Metabolism and Pharmacokinetics Laboratory , Zydus Research Centre , Ahmedabad , India
| | - Nirav Modi
- a Bioanalytical/Drug Metabolism and Pharmacokinetics Laboratory , Zydus Research Centre , Ahmedabad , India
| | - Pinakin Patel
- a Bioanalytical/Drug Metabolism and Pharmacokinetics Laboratory , Zydus Research Centre , Ahmedabad , India
| | - Yogesh Wagh
- c Pharmaceutical Technology Centre, Cadila Healthcare Limited , Ahmedabad , India
| | - Alex George
- c Pharmaceutical Technology Centre, Cadila Healthcare Limited , Ahmedabad , India
| | - Nirmal Desai
- b Department of Chemistry , St Xavier's College (Autonomous) , Ahmedabad , India
| | - Nuggehally R Srinivas
- a Bioanalytical/Drug Metabolism and Pharmacokinetics Laboratory , Zydus Research Centre , Ahmedabad , India
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Fu DJ, Turkoz I, Walling D, Lindenmayer JP, Schooler NR, Alphs L. Paliperidone palmitate once-monthly maintains improvement in functioning domains of the Personal and Social Performance scale compared with placebo in subjects with schizoaffective disorder. Schizophr Res 2018; 192:185-193. [PMID: 28454922 DOI: 10.1016/j.schres.2017.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/17/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Evaluate the effect of paliperidone palmitate once-monthly (PP1M) injectable on the specific functioning domains of the Personal and Social Performance (PSP) scale in patients with schizoaffective disorder (SCA) participating in a long-term study. METHODS This study (NCT01193153) included both in- and outpatient subjects with SCA experiencing an acute exacerbation of psychotic and mood symptoms. Subjects were treated with PP1M either as monotherapy or in combination with antidepressants or mood stabilizers during a 25-week open-label (OL) phase. Stabilized subjects were randomly assigned 1:1 (PP1M or placebo) into a 15-month double-blind (DB) relapse-prevention period. Functioning of the randomized subjects during OL and DB phases was evaluated using the PSP scale (four domains: socially useful activities, personal/social relationships, self-care, and disturbing/aggressive behaviors). Three statistical approaches were utilized to analyze PSP scores to assess robustness and consistency of findings. No adjustments were made for multiplicity. RESULTS 334 of 667 enrolled subjects were stabilized with PP1M, randomly assigned to PP1M (n=164) or placebo (n=170) in the DB phase, and included in this analysis. Improvements in all PSP domain scores were observed during the OL phase and were maintained during the DB phase with PP1M, but decreased with placebo. Differences compared to placebo were significant in all four PSP domains during the DB phase (P≤0.008). CONCLUSION The analysis in this study showed that PP1M improves functioning, as measured by the four PSP domain scores, in symptomatic subjects with SCA. Functioning was maintained compared with placebo.
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Affiliation(s)
- Dong-Jing Fu
- Janssen Research & Development, LLC, Titusville, NJ 08560, USA.
| | - Ibrahim Turkoz
- Janssen Research & Development, LLC, Titusville, NJ 08560, USA
| | - David Walling
- Collaborative Neuroscience Network, Inc, Garden Grove, CA, USA
| | | | | | - Larry Alphs
- Janssen Scientific Affairs, LLC, Titusville, NJ, 08560, USA
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Pharmacokinetics of a Long-Acting Nanoformulated Dolutegravir Prodrug in Rhesus Macaques. Antimicrob Agents Chemother 2017; 62:AAC.01316-17. [PMID: 29061742 PMCID: PMC5740312 DOI: 10.1128/aac.01316-17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/28/2017] [Indexed: 01/24/2023] Open
Abstract
A nanoformulated myristoylated dolutegravir prodrug (NMDTG) was prepared using good laboratory practice protocols. Intramuscular injection of NMDTG (118 ± 8 mg/ml, 25.5 mg of DTG equivalents/kg of body weight) to three rhesus macaques led to plasma DTG levels of 86 ± 12 and 28 ± 1 ng/ml on days 35 and 91, respectively. The NMDTG platform showed no significant adverse events. Further modification may further extend the drug's apparent half-life for human use.
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