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Novel Antiviral Therapy for RSV Infection

Summary and Comment |
August 20, 2014

Novel Antiviral Therapy for RSV Infection

  1. Larry M. Baddour, MD

An oral RSV cell-entry inhibitor was effective in an adult challenge study.

  1. Larry M. Baddour, MD

There is no proven antiviral therapy available for the treatment of respiratory syncytial virus (RSV) infection — a condition that carries significant morbidity and mortality risks in susceptible groups, including young infants, the elderly, and immunocompromised individuals.

In a recent manufacturer-funded, double-blind, placebo-controlled challenge study, researchers sought to establish proof of concept for a novel oral agent, GS-5806, that interferes with RSV entry by blocking viral-envelope fusion with the host-cell membrane. Healthy adults were inoculated intranasally with a clinical strain of RSV and then, when they tested positive for RSV infection (or on day 5, whichever came first), were randomized to receive GS-5806 (in one of various dosages) or placebo.

Viral loads (the primary end point), determined after the first dose of therapy through the 12th day after viral inoculation, were lower in participants who received GS-5806 than in those who received placebo. In addition, the secondary end points of mucus weight and symptom scores were reduced in GS-5806 recipients in all treatment groups. Few participants experienced adverse events, and no treatment-related events were serious. Elevated alanine aminotransferase levels and low neutrophil counts were more common among GS-5806 recipients, whereas elevated aspartate aminotransferase levels were more common among placebo recipients.

Comment

As an editorialist noted, this adult challenge study is important for at least two reasons: It provides preliminary evidence of the effectiveness of GS-5806 in modulating RSV infection and thereby suggests that fusion of viral-surface proteins and host-cell membranes is a valid target for antiviral compounds to treat such infection.

  • Disclosures for Larry M. Baddour, MD at time of publication Editorial boards UpToDate Leadership positions in professional societies American Heart Association (Chairman, Rheumatic Fever, Endocarditis, Kawasaki Disease Committee)

Citation(s):

Reader Comments (1)

S c Bhawnani Physician, Pediatric Subspecialty, India

Can the findings of this study be extrapolated to the infants in which RSVP infection is more common and more serious

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