Laninamivir and its prodrug, CS-8958: long-acting neuraminidase inhibitors for the treatment of influenza

Antivir Chem Chemother. 2010;21(2):71-84. doi: 10.3851/IMP1688.

Abstract

Oseltamivir and zanamivir are currently licensed worldwide for influenza treatment and chemoprophylaxis. Both drugs require twice-daily administration for 5 days for treatment. A new influenza drug, laninamivir (code name R-125489), and its prodrug form, CS-8958 (laninamivir octanoate or laninamivir prodrug), which are long-acting neuraminidase inhibitors, are introduced in this review. Laninamivir potently inhibited the neuraminidase activities of various influenza A and B viruses, including subtypes N1-N9, pandemic (2009) H1N1 virus, highly pathogenic avian influenza (HPAI) H5N1 viruses and oseltamivir-resistant viruses. Because of the long retention of laninamivir in mouse lungs after an intranasal administration of CS-8958, therapeutic administration of a single dose of CS-8958 showed superior efficacy to repeated administrations of zanamivir or oseltamivir in animal infection models for influenza A and B viruses. These include pandemic (2009) H1N1 virus and HPAI H5N1 virus. Prophylactic single administration of CS-8958, as early as 7 days prior to infection, also showed superior efficacy. Finally, the potential of a single inhalation of CS-8958 for influenza patients was demonstrated by clinical studies, and CS-8958 has been approved and is commercially available as Inavir(®) (Daiichi Sankyo Co., Ltd, Tokyo) in Japan.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiviral Agents / pharmacology*
  • Disease Models, Animal
  • Drug Administration Routes
  • Drug Administration Schedule
  • Guanidines
  • Humans
  • Influenza, Human* / drug therapy
  • Mice
  • Neuraminidase* / antagonists & inhibitors
  • Orthomyxoviridae / pathogenicity
  • Orthomyxoviridae / physiology
  • Oseltamivir / pharmacology*
  • Pandemics
  • Prodrugs / pharmacology*
  • Pyrans
  • Rats
  • Sialic Acids
  • Zanamivir / analogs & derivatives*
  • Zanamivir / pharmacology

Substances

  • Antiviral Agents
  • CS 8958
  • Guanidines
  • Prodrugs
  • Pyrans
  • Sialic Acids
  • Oseltamivir
  • laninamivir
  • Neuraminidase
  • Zanamivir