Dectova (zanamivir) / GSK - LARVOL DELTA

Occurrence of influenza antivirals and resistance development in influenza A viruses in aquatic environments: A risk assessment. (PubMed, PLoS One) - "This study aimed to assess the environmental risk posed by four IAs-oseltamivir carboxylate (OC), zanamivir (ZA), peramivir (PE), and amantadine (AM)-based on their potential for environmental release, environmental stability, and induction of antiviral resistance...However, in uncomplicated influenza among otherwise healthy individuals, the clinical benefit is limited, and the risk of resistance development should be carefully considered. Among the evaluated antivirals, ZA showed the lowest environmental risk and should be preferred when feasible."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Comparative Phytochemical and Antiviral Characteristics of Dipsacus asperoides and Phlomis umbrosa Against Influenza A Virus: LC-QTOF-MS Profiling and Exploratory Network Pharmacology. (PubMed, Plants (Basel)) - "The network pharmacology results should be interpreted as hypothesis-generating rather than mechanistic confirmation and suggest candidate host-response pathways that can guide targeted follow-up experiments. These findings support phytochemical differentiation of the two species while providing a comparative framework for future investigation of their antiviral properties."

Journal • Infectious Disease • Influenza • Respiratory Diseases • CASP3 • IL6 • MAPK1 • RELA

Zanamivir Treatment of Vascular Permeability in Dengue (ZAP-DENGUE) (clinicaltrials.gov) - P2 | N=74 | Recruiting | Sponsor: George Washington University | Trial completion date: Sep 2026 ➔ Aug 2027 | Trial primary completion date: Sep 2026 ➔ Aug 2027

Trial completion date • Trial primary completion date • Dengue Fever

An Intravenous (IV) Zanamivir Pharmacokinetics (PK) Study in Hospitalized Neonates and Infants With Influenza Infection (clinicaltrials.gov) - P2 | N=8 | Completed | Sponsor: GlaxoSmithKline | Recruiting ➔ Completed | N=12 ➔ 8 | Trial primary completion date: Apr 2026 ➔ Jan 2026

Enrollment change • Trial completion • Trial primary completion date • Infectious Disease • Influenza • Musculoskeletal Pain • Respiratory Diseases

Mechanistic insights into flavonoid-mediated regulation of human influenza virus replication. (PubMed, Virology) - "Influenza A virus (IAV) remains a major global health concern due to its rapid mutation rate, antigenic variability, and the emergence of resistance to frontline antivirals such as oseltamivir and zanamivir...The ability of plant-derived compounds to inhibit viral replication underscores their potential as leads for next-generation influenza therapeutics. Nonetheless, rigorous in vivo studies, mechanistic elucidation, and pharmacokinetic evaluations are essential to advance these candidates toward clinical translation."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases

Antiviral treatment for influenza. (PubMed, Philos Trans R Soc Lond B Biol Sci) - "NAIs, including oseltamivir, zanamivir, peramivir and laninamivir, block viral release, while polymerase inhibitors such as baloxavir disrupt viral RNA replication...Favipiravir and newer polymerase inhibitors are under investigation...Overall, timely antiviral use is critical to reducing influenza's burden. This article is part of the Theo Murphy meeting issue 'Evaluating anti-infective drugs'."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases

Zanamivir-Amantadine Conjugate: A Dual-Action Agent with Broad-Spectrum Synergistic Antiviral Efficacy. (PubMed, J Med Chem) - "Notably, a single intravenous dose of 7j fully protected mice from a lethal H1N1 challenge. Our work demonstrates that the rational fusion of ZMV and Aman achieves synergistic multimechanistic antiviral activity with enhanced efficacy and safety, offering a new strategy for the development of next-generation anti-influenza drugs."

Journal • Infectious Disease • Influenza • Respiratory Diseases

A literature review of influenza chemoprophylaxis and treatment in children. (PubMed, Germs) - "In Europe, oseltamivir, zanamivir, and baloxavir marboxil are recommended for the treatment or prophylaxis of influenza in adults and children, while the Food and Drug Administration added intravenous peramivir to the list of anti-influenza drugs...However, there are still discussions related to the duration of prophylaxis, with shorter periods of administration being explored, or the most efficient treatment dosage program (whether it is the conventional dosage of 3 mg/kg/dose for children <40 kg or 75 mg for adults, twice daily, compared to a double dosage administration program). When faced with an old disease, it is essential to constantly assess the efficacy of conventional molecules and dosages, along with new antivirals or complementary medication."

Journal • Review • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

Exploring the Anti-Influenza Activity of closo-Borate Platforms: Structure-Activity Relationship of Amino Acid-Functionalized closo-Dodecaborate Derivatives Against Influenza Virus A/Cheboksary/125/2020 (H1N1)pdm09. (PubMed, Molecules) - "Cross-platform comparison revealed that the dodecaborate-tryptophan conjugate Na22 exhibited comparable efficacy to its lead decaborate analog against the Orenburg strain while demonstrating potent activity (IC50 = 5.0 µg/mL) against the Cheboksary strain with reduced susceptibility to neuraminidase inhibitors (oseltamivir; zanamivir) and complete resistance to M2 channel blockers. The histidine-based conjugate Na23 also showed significant efficacy against the Cheboksary strain, while methionine and lactam derivatives (Na24; Na25) remained inactive. This work confirms boron clusters as versatile platforms for antiviral development and establishes structure-activity relationships crucial for optimizing both B10 and B12-based therapeutics against resistant influenza strains."

Journal • Infectious Disease • Influenza • Respiratory Diseases

A multivalent nanobody-drug conjugate to prevent and treat influenza virus infections. (PubMed, Proc Natl Acad Sci U S A) - "VHHkappa-Zan4 affords protection even when given intranasally weeks prior to a challenge with a lethal dose of IAV. This type of adduct can therefore be applied prophylactically and therapeutically and does not require prior immunization for protection against a lethal dose of IAV."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Exploring Drug Repurposing for Influenza A (H3N2) Virus: A Computational Approach to Identifying Commercialized Drugs Targeting Hemagglutinin, Neuraminidase, and Nucleoprotein. (PubMed, J Chem Inf Model) - "Despite the availability of antiviral treatments such as Oseltamivir, Zanamivir, and more recently, Baloxavir Marboxil, their efficacy is limited by resistance, side effects, and the rapid mutation of the virus...Finally, free-energy calculations were carried out to assess binding affinities, ranking the drugs based on their potential inhibitory effects and providing critical insights for their further development as antiviral treatments. This integrated computational approach offers a faster, cost-effective pathway for discovering novel influenza therapies with significant implications for pandemic preparedness."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Zanamivir Treatment of Vascular Permeability in Dengue (ZAP-DENGUE) (clinicaltrials.gov) - P2 | N=74 | Recruiting | Sponsor: George Washington University | Trial completion date: Sep 2025 ➔ Sep 2026 | Trial primary completion date: Sep 2025 ➔ Sep 2026

Trial completion date • Trial primary completion date • Dengue Fever

Epidemiological and genomic surveillance of influenza A virus (pdm09 H1N1 and H3N2) strains from 2017 to 2025 in Tianjin, China. (PubMed, Virol Sin) - "Moreover, no antigenic variants were found in clinical isolates during the recent influenza seasons, though reduced sensitivity to oseltamivir and zanamivir was observed in individual strains. Our surveillance highlights the epidemiology and evolution of IAV before and after the COVID-19 pandemic in Tianjin."

Journal • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases

Zanamivir exposure in healthy rats and rats with acute lung injury. (PubMed, Ann Med) - "The absolute bioavailability of nebulised zanamivir was 1.91%. Our findings confirm PK superiority of INH administration to achieve local intrapulmonary exposition and indicate that ALI significantly impairs zanamivir penetration into the lungs from systemic circulation."

Journal • Preclinical • Acute Lung Injury • Inflammation • Pneumonia • Respiratory Diseases

An Intravenous (IV) Zanamivir Pharmacokinetics (PK) Study in Hospitalized Neonates and Infants With Influenza Infection (clinicaltrials.gov) - P2 | N=12 | Recruiting | Sponsor: GlaxoSmithKline | Trial completion date: Dec 2026 ➔ Apr 2026 | Trial primary completion date: Dec 2026 ➔ Apr 2026

Trial completion date • Trial primary completion date • Infectious Disease • Influenza • Musculoskeletal Pain • Respiratory Diseases

Targeted recruitment of immune effector cells for rapid eradication of influenza virus infections. (PubMed, Proc Natl Acad Sci U S A) - "Because the neuraminidase inhibition replicates the chemotherapeutic mechanism of zanamivir and oseltamivir, while rhamnose and DNP recruit endogenous antibodies much like an anti-influenza vaccine, zanDR reproduces most of the functions of current methods of protection against influenza virus infections. Importantly, studies on cells in culture demonstrate that both of the above protective mechanisms remain highly functional in the zanDR conjugate, while studies in lethally infected mice with advanced-stage disease establish that a single intranasal dose of zanDR not only yields 100% protection but also reduces lung viral loads faster and ~1,000× more thoroughly than current antiviral therapies. Since zanDR also lowers secretion of proinflammatory cytokines and protects against virus-induced damage to the lungs better than current therapies, we suggest that combining an immunotherapy with a chemotherapy in single pharmacological agent constitutes a promising..."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Synergistic activity of an RNA polymerase PA-PB1 interaction inhibitor with oseltamivir against human and avian influenza viruses in cell culture and in ovo. (PubMed, Antiviral Res) - "In this short communication, we investigated the effects of combinations of the PA-PB1 interaction inhibitor 54 with oseltamivir carboxylate (OSC), zanamivir (ZA), favipiravir (FPV), and baloxavir marboxil (BXM) on the inhibition of influenza A and B virus replication in vitro...Finally, we observed that 54 enhances OSC protective effect against avian IV replication in the embryonated eggs model. Our findings represent an advance in the development of alternative therapeutic strategies against both human and avian IV infections."

Journal • Preclinical • Infectious Disease • Influenza • Respiratory Diseases

Zanamivir Treatment of Vascular Permeability in Dengue (ZAP-DENGUE) (clinicaltrials.gov) - P2 | N=74 | Recruiting | Sponsor: George Washington University | Phase classification: P1 ➔ P2

Phase classification • Dengue Fever

AD ASTRA: A Phase 2 Trial Comparing Antiviral Treatments in Early Symptomatic Influenza (clinicaltrials.gov) - P2 | N=3000 | Recruiting | Sponsor: University of Oxford | N=250 ➔ 3000 | Trial completion date: Jan 2025 ➔ Jan 2027 | Trial primary completion date: Dec 2024 ➔ Jan 2027

Enrollment change • Trial completion date • Trial primary completion date • Infectious Disease • Influenza • Respiratory Diseases

LOW ANTIVIRAL RESISTANCE IN INFLUENZA A AND B VIRUSES ISOLATED IN MEXICO FROM 2010 TO 2023. (PubMed, Antiviral Res) - "The most widely used class of antivirals available for Influenza treatment are the neuraminidase inhibitors (NAI) Oseltamivir and Zanamivir...No genetic mutations were identified in Influenza A(H3N2) and IBV. Overall, these results show that in Mexico the rate of NAI resistance is low (0.6%), but it is essential to continue the Influenza surveillance in order to understand the drug susceptibility of circulating strains."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Zanamivir Treatment of Vascular Permeability in Dengue (ZAP-DENGUE) (clinicaltrials.gov) - P1 | N=74 | Recruiting | Sponsor: George Washington University | Not yet recruiting ➔ Recruiting | Trial completion date: Jun 2024 ➔ Sep 2025 | Trial primary completion date: Jun 2024 ➔ Sep 2025

Enrollment open • Trial completion date • Trial primary completion date • Dengue Fever

Heteromultivalent Ligand Display on Reversible Self-Assembled Monolayers (rSAMs): A Fluidic Platform for Tunable Influenza Virus Recognition. (PubMed, ACS Appl Mater Interfaces) - "Hence, an rSAM prepared from solutions containing 15% SA and 10% Zan showed an exceptionally high affinity and selectivity for the avian IAV H7N9 (K = 11 fM) that strongly exceeded the affinity for other subtypes (H3N2, H5N1, H1N1). Changing the SA/Zan ratio resulted in changes in the relative preference between the four tested subtypes, suggesting this to be a key parameter for rapid adjustments of both virus affinity and selectivity."

Journal • Infectious Disease • Influenza • Respiratory Diseases

An Intravenous (IV) Zanamivir Pharmacokinetics (PK) Study in Hospitalized Neonates and Infants With Influenza Infection (clinicaltrials.gov) - P2 | N=12 | Recruiting | Sponsor: GlaxoSmithKline | Trial completion date: Dec 2023 ➔ Dec 2026 | Trial primary completion date: Dec 2023 ➔ Dec 2026

Trial completion date • Trial primary completion date • Infectious Disease • Influenza • Musculoskeletal Pain • Respiratory Diseases

Rationale and Design of the Zanamivir for the treatment of vascular Permeability in Dengue fever (ZAP-DENGUE) Trial (ASTMH 2023) - "The ZAP-DENGUE is the first clinical trial of human sialidase inhibition to target vascular permeability- the main cause of death in dengue infection. If data support preliminary safety and efficacy, further studies powered to demonstrate clinical efficacy would be needed."

Late-breaking abstract • Dengue Fever • Infectious Disease • Influenza • Respiratory Diseases • SDC1

Zanamivir Treatment of Vascular Permeability in Dengue (ZAP-DENGUE) (clinicaltrials.gov) - P1 | N=74 | Not yet recruiting | Sponsor: George Washington University | Trial completion date: Aug 2023 ➔ Jun 2024 | Trial primary completion date: Aug 2023 ➔ Jun 2024

Trial completion date • Trial primary completion date • Dengue Fever