Peramivir

BeschreibungPeramivir is a neuraminidase (NA) inhibitor that was approved in Japan in 2010 for treatment of patients with influenza. It is the only NA inhibitor available for IV use and is the first of two NA inhibitors approved in 2010, the second being the inhaled drug laninamivir octanoate . Peramivir is the only NA inhibitor approved for IV use,which gives it a unique place in influenza treatment for seriously ill patients. Peramivir was discovered using structure-based drug design and is synthesized in six steps from Boc-protected methyl (1S,4R)-4-amino-cyclopent-2-enecarboxylate, which is prepared from 2-azabicyclo[2.2.1]hept-5-en-3-one. Cycloaddition of the cyclopentene olefin with a nitrile oxide provided an intermediate fused cyclopentane-dihydroisoxazole. Hydrogenolysis and acetylation set up a fully functionalized cyclopentane with all four stereocenters established. Deprotection of the amine and acid groups was followed by installation of the guanidine moiety to provide peramivir. Like zanamivir and oseltamivir, peramivir is a potent inhibitor of influenza virus A and B NA [strain A(H1N1) IC50= 0.34 nM; strain A(H3N2) IC50= 0.60 nM; strain B IC50= 1.36 nM]. However, peramivir is less potent against oseltamivirresistant viruses that have the H275Y NA mutation. These viruses remain sensitive to zanamivir. Peramivir is active against influenza A and B viruses and has a lowenzymatic off-rate, suggesting that it could inhibitNAactivity for a prolonged period and allow lower frequency of dosing. Peramivir has proven efficacious in preclinical animal models of influenza infection.

VerwendenPeramivir is a new antiviral agent for influenza treatment; it can be used as neuraminidase inhibitor for treating human and avian influenza