remdesivir oral (GS-5734 oral) / Lupin - LARVOL DELTA

Efficacy of oral remdesivir in treating feline infectious peritonitis: a prospective observational study of 29 cats. (PubMed, J Feline Med Surg) - "Molnupiravir was offered as a rescue therapy for cats that relapsed.ResultsIn total, 25 (86%) cats entered remission and survived beyond 6 months (range 6-27). The survival rate in non-effusive cats was significantly lower; therefore, an increased dose rate or frequency of administration should be considered in these cats. Oral remdesivir is a viable antiviral option where GS-441524 is unavailable."

Journal • Observational data • Infectious Disease • Novel Coronavirus Disease • Ophthalmology

High-dose induction therapy and treatment termination criteria for feline infectious peritonitis with remdesivir, GS-441524 and adjunctive mefloquine: 46 cases (2023). (PubMed, J Small Anim Pract) - "In some cats with feline infectious peritonitis a high-dose induction protocol, using acute-phase proteins and the albumin/globulin ratio for treatment cessation, enabled a shorter treatment period than the conventional 12 weeks, without observed recurrence. The criteria used in this study appear adequate for determining appropriate times for feline infectious peritonitis treatment cessation."

Journal

Predictive factors associated with short-term mortality in cats with feline infectious peritonitis treated with remdesivir or GS-441524 or both. (PubMed, J Vet Intern Med) - "Increased plasma LDH activity might be useful for predicting short-term mortality, guiding monitoring, and establishing prognosis in cats with FIP."

Biomarker • Clinical • Journal • Infectious Disease • Novel Coronavirus Disease

COVID-19: An Update on Epidemiology, Prevention and Treatment, September-2023. (PubMed, Infect Dis Clin Microbiol) - "At the current phase of the pandemic, nirmatrelvir/ritonavir, remdesivir, molnupiravir, sotrovimab (for patients from XBB.1.5 variant dominant settings), and convalescent plasma can be considered for the treatment of high-risk early-stage outpatients with COVID-19, while hospitalized patients with more severe disease can be treated with dexamethasone, anti cytokines including tocilizumab, sarilumab, baricitinib, and tofacitinib and antithrombotic agents including enoxaparin. Remdesivir oral analogues and ensitrelvir fumarate are promising agents for treating acute COVID-19, which are in phase trials now; however, ivermectin, fluvoxamine, and metformin were shown to be ineffective."

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

A viral RNA-dependent RNA polymerase inhibitor VV116 broadly inhibits human coronaviruses and has synergistic potency with 3CLpro inhibitor nirmatrelvir. (PubMed, Signal Transduct Target Ther) - "Although Paxlovid and molnupiravir have received emergency approval from the FDA, some side effect concerns have emerged, and the possible oral agents are still limited, resulting in optimized drug development becoming an urgent requirement. An oral remdesivir derivative, VV116, has been reported to have promising antiviral effects against SARS-CoV-2 and positive therapeutic outcomes in clinical trials...When co-administrated with ritonavir, the combination of VV116 and nirmatrelvir showed significantly enhanced antiviral potency with noninteracting pharmacokinetic properties in mice. Our findings will facilitate clinical treatment with VV116 or VV116+nirmatrelvir combination to fight coronavirus infection."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Efficacy of Oral Remdesivir Compared to GS-441524 for Treatment of Cats with Naturally Occurring Effusive Feline Infectious Peritonitis: A Blinded, Non-Inferiority Study. (PubMed, Viruses) - "These findings suggest that both orally administered GS-441524 and remdesivir are safe and effective anti-viral medications for the treatment of effusive FIP. Further optimization of the first 48 h of treatment is needed."

Head-to-Head • Journal • Infectious Disease • Novel Coronavirus Disease

Outcomes of treatment of cats with feline infectious peritonitis using parenterally administered remdesivir, with or without transition to orally administered GS-441524. (PubMed, J Vet Intern Med) - "Parenteral administration of remdesivir and oral administration of GS-441524 are effective and well-tolerated treatments for FIP. Early emphasis on clinical, and later emphasis on clinicopathologic response, appears prudent when monitoring treatment efficacy."

Journal • Infectious Disease • Novel Coronavirus Disease

Thirty-two cats with effusive or non-effusive feline infectious peritonitis treated with a combination of remdesivir and GS-441524. (PubMed, J Vet Intern Med) - "We describe the effective use of injectable remdesivir and PO GS-441524 for the treatment of FIP in cats. Success occurred using different treatment protocols and with different presentations of FIP including cats with ocular and neurological involvement."

Journal • Infectious Disease • Novel Coronavirus Disease

A Rare Case of Eosinophilic Pneumonia Precipitated by E-cigarette Presenting as a COVID-19 Mimic (ATS 2023) - "He received, oxygen by nasal cannula, remdesivir, dexamethasone, and antibiotics for possible COVID-19 infection with bacterial pneumonia. Day 2, steroid was transitioned to oral, Remdesivir was discontinued...He received, oxygen by nasal cannula, remdesivir, dexamethasone, and antibiotics for possible COVID-19 infection with bacterial pneumonia. Day 2, steroid was transitioned to oral, Remdesivir was discontinued...However as evidenced in this case, rapid steroid initiation remains the mainstay of treatment in these patients with complete resolution. Our case highlights that AEP and EVALI should be considered in the differential for AHRF in a previously young healthy patients, especially as vaping has increased significantly in recent years."

Clinical • Cough • Eosinophilia • Infectious Disease • Novel Coronavirus Disease • Otorhinolaryngology • Pneumonia • Pulmonary Disease • Respiratory Diseases

"And why not compare "PO remdesivir" to IV remdesivir in hospitalized patients!" (@DrToddLee)

Clinical

Oral GS-441524 derivatives: Next-generation inhibitors of SARS-CoV-2 RNA-dependent RNA polymerase. (PubMed, Front Immunol) - "Therefore, oral GS-441524 derivatives (VV116, ATV006, and GS-621763; version 2.0, targeting highly conserved viral RdRp) could be considered as game-changers in treating COVID-19 because oral administration has the potential to maximize clinical benefits, including decreased duration of COVID-19 and reduced post-acute sequelae of SARS-CoV-2 infection, as well as limited side effects such as hepatic accumulation. This review summarizes the current research related to the oral derivatives of GS-441524, and provides important insights into the potential factors underlying the controversial observations regarding the clinical efficacy of remdesivir; overall, it offers an effective launching pad for developing an oral version of GS-441524."

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

"Why does no-one force Gilead to have GS-441524 approved? It's bioavailable when administrated orally and Remdesivir is converted to it after i.v. administration anyway." (@RolandSB13)

Comparative evaluation of authorized drugs for treating Covid-19 patients. (PubMed, Health Sci Rep) - "We found that molnupiravir and paxlovid are available for oral use, and remdesivir is for only hospitalized patients. All authorized drugs are effective in inhibiting viral replication for most SARS-CoV-2 variants. Therefore, along with vaccines, these drugs might potentially aid in fighting the Covid-19 pandemic."

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

Oral remdesivir derivative VV116 is a potent inhibitor of respiratory syncytial virus with efficacy in mouse model. (PubMed, Signal Transduct Target Ther) - No abstract available

Journal • Preclinical • Respiratory Diseases

Oral antivirals for the prevention and treatment of SARS-CoV-2 infection. (PubMed, AIDS Rev) - "Compared to currently available monoclonal antibodies and remdesivir, where parenteral administration is required, oral antivirals offer treatments in an outpatient setting with dissemination available on a larger scale. In response to this need at 2021's end, regulatory agencies provided emergency use authorization for both molnupiravir and nirmatrelvir...Each is given for 5 days and can reduce disease progression by 30% and 89%, respectively. The advent of additional oral antivirals, the assessment of combination therapies, the formulation of extended-release medications, and their benefit for both early treatment and prophylaxis will likely transform the landscape of the COVID-19 pandemic."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

[VIRTUAL] Tick tock...where and when can we give toc? Review of COVID-19 patients receiving tocilizumab in a non critical care setting (BTS WM-I 2021) - "Introduction The REMAP-CAP trial demonstrated the positive effects of interleukin-6 receptor antagonists (tocilizumab and sarilumab), on mortality in COVID-19 patients managed in a critical care setting...Prior to January 2021 standard ward level care included IV antibiotics, IV remdesivir, oral dexamethasone and non-invasive ventilation...Conclusion This data supports the use of tocilizumab in patients with COVID-19 disease, noting its positive effect on hospital mortality for COVID-19 patients on non-invasive respiratory support but not requiring critical care. Moreover, the limited side effect profile witnessed suggests tocilizumab can be safely administered in a non-critical care setting."

Clinical • Review • Critical care • Infectious Disease • Novel Coronavirus Disease

What would an antiviral pill mean for the fight against Covid 19 (YouTube) - "Merck and Ridgeback Biotherapeutics announced on Friday early result that indicate their experimental oral antiviral drug molnupiravir might halve the risk of death or hospitalization from Covid-19....Most people have heard of Tamiflu, and they've heard of acyclovir,' said Dr. Myron Cohen...Acyclovir is a type of antiviral used to treat chickenpox, herpes and shingles. 'We didn't develop a ton of other antivirals,' he said. Another antiviral, remdesivir, is currently the only drug approved by the FDA for the treatment of Covid-19."

Video

Design and development of an oral remdesivir derivative VV116 against SARS-CoV-2. (PubMed, Cell Res) - No abstract available

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

[VIRTUAL] A Rare Case of COVID-19 Related Necrotizing Myopathy (ACRM 2021) - "He was found to have COVID-19 pneumonia.Interventions: Patient was treated with remdesivir and oral dexamethasone. He was transferred to the ICU for 9 days where he received convalescent plasma, intravenous methylprednisolone, and high flow oxygen...His atorvastatin was held, and steroids were tapered... Timely recognition of COVID-19 related myopathy may prevent serious necrotizing muscle injury"

Clinical • Cardiovascular • Endocrine Disorders • Immunology • Infectious Disease • Musculoskeletal Pain • Myositis • Novel Coronavirus Disease • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • MRI

Making COVID-19 clinical trials work with the help of the VCU Wright Center: The remdesivir story (University of Rochester Medical Center (URMC)) - "'Here at VCU, what we did was help translate research into an evidence-based drug that is available not just in the U.S., but around the world for patients with COVID,' Dr. Sanyal said. 'The ideal approach in fighting COVID is to take a drug like remdesivir that attacks the virus, and to use another drug that helps reduce the immune reaction to the virus. Together, you can get both ends of the disease process.'"

Media quote

"Tenofovir blocks SARS-CoV-2 polymerase in vitro (oral agent - remdesivir is an intravenous agent that blocks the polymerase). Can it be used, tested, harnessed? Article we wrote. https://t.co/tHV5veSjTa" (@MonicaGandhi9)

Preclinical • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Lupin gets CDSCO panel nod to bioavailability study of Remdesivir Oral Solution for COVID 19 (Medical Dialogues) - "The Subject Expert Committee (SEC) functional under the Central Drugs Standard Control Organization (CDSCO) has opined for the grant of permission to drug maker Lupin to conduct the bioavailability study of Remdesivir Oral Solution 100 mg/5ml. However, the permission comes with a condition that the study should be conducted in male human subjects in fasting condition only. The recommendation came in the wake of the proposal presented by the firm along with the animal study data of pharmacokinetics of the proposed Remdesivir formulation and Absolute bioavailability study protocol....Further, it was suggested to submit the revised protocol as per the committee's recommendation to CDSCO for approval."

New trial • Infectious Disease • Novel Coronavirus Disease