Rapivab (peramivir) / BioCryst, Shionogi - LARVOL DELTA

Improving Antiviral Use in Children Hospitalized with Influenza (PAS 2025) - "Outcome measure was the percentage of encounters with at least one dose of a hospital formulary antiviral (oseltamivir or peramivir) administered. Baseline consisted of 143 encounters with antiviral treatment administered in 74.8% of encounters. There has not been a shift in the center line in the outcome measure, though 7 of last 8 points are above centerline (Figure 2). Special cause variation (SCV) was seen in our process measure with a shift in the center line from 4.9 hours to 2.4 hours following educational interventions (Figure 3)."

Clinical • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

How to manage antivirals in critically ill patients with Influenza? (PubMed, Clin Microbiol Infect) - "Neuraminidase inhibitors constitute the vast majority of antivirals currently prescribed for influenza. The most commonly prescribed NAI to date is oseltamivir. While its efficacy in non-severe cases of influenza is well established, the evidence for its efficacy in critically ill patients is based on less robust studies, as no randomised controlled trials have been conducted in this population. Limited data on oseltamivir pharmacokinetics is available in critically ill patients. The selection of A(H1N1)pdm09 resistant variants to oseltamivir is particularly problematic in critically-ill patients hospitalised in intensive care units. Data on other antivirals, including NAIs (i.e., zanamivir, peramivir and laninamivir) or baloxavir marboxil in critically ill patients are scarce. Further research is needed to develop new drugs and assess their efficacy in critically ill patients and to better assess the effect of oseltamivir in this population."

Journal • Review • Critical care • Infectious Disease • Influenza • Respiratory Diseases

FIFTY-YEAR ANALYSIS OF INFLUENZA VACCINE EFFECTIVENESS AND ANTIVIRAL USE PATTERNS THROUGH MACHINE LEARNING: IMPLICATIONS FOR PAEDIATRIC INFLUENZA MANAGEMENT (ESPID 2025) - "Data were stratified by virus subtypes, including Influenza A(H1N1), A(H3N2), and Influenza B, as well as by the use of major antivirals such as Amantadine, Rimantadine, Zanamivir, Oseltamivir, Peramivir, and Baloxavir...Conclusions/Learning Points This analysis highlights the dynamic nature of influenza vaccine effectiveness and antiviral medication consumption over five decades. The findings underscore the necessity of ongoing research, global surveillance, and adaptability in influenza prevention and treatment strategies to address changing epidemiological patterns, particularly in vulnerable populations such as children."

Machine learning • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

Preparation and comprehensive preclinical study of Peramivir inhalation solution: Achieving accurate drug delivery. (PubMed, Biomed Pharmacother) - "In this study, we focused on the reformulation of Peramivir from intravenous to inhalation administration, conducting comprehensive research on its toxicity, tissue distribution, pharmacokinetics, and pharmacodynamics. We demonstrated that PIS, compared to intravenous administration, exhibited heightened local drug exposure in lung tissues, longer exposure duration, slower elimination, and exhibited good tolerability without specific safety concerns."

Journal • Preclinical • Infectious Disease • Influenza • Respiratory Diseases

New Function for Safety Signal Monitoring in MID-NET®: The Case of an Anti-COVID-19 Drug. (PubMed, Clin Transl Sci) - "We monitored the safety signals of an anti-COVID-19 drug (combination of tixagevimab and cilgavimab) and compared them with those of two controls (peramivir and the combination of casirivimab and imdevimab) to examine the practical utility of this new tool. Our study provided helpful information (e.g., new safety signals) on many outcomes at multiple time points, which could enhance the understanding of drug safety profiles soon after approval. Our function can be used to rapidly and continuously monitor drug safety signals and contribute to strengthening drug safety monitoring in Japan."

Journal • Infectious Disease • Novel Coronavirus Disease

Antiviral Susceptibility of Influenza A(H5N1) Clade 2.3.2.1c and 2.3.4.4b Viruses from Humans, 2023-2024. (PubMed, Emerg Infect Dis) - "In the neuraminidase inhibition assay, all viruses displayed susceptibility to neuraminidase inhibitor antiviral drugs oseltamivir, zanamivir, peramivir, laninamivir, and AV5080...All viruses were susceptible to polymerase inhibitors baloxavir and tivoxavir and to polymerase basic 2 inhibitor pimodivir with 50% effective concentrations in low nanomolar ranges. Because drug-resistant viruses can emerge spontaneously or by reassortment, close monitoring of antiviral susceptibility of H5N1 viruses collected from animals and humans by using sequence-based analysis supplemented with phenotypic testing is essential."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Fatal Cerebral Complications in Disseminated Mucormycosis after Influenza-associated Pneumonia in an Immunocompromised Patient: An Autopsy Case Report (AAN 2025) - "Despite treatment with cefepime, peramivir, and increased corticosteroids, her condition worsened, leading to left hemiplegia and severe consciousness disturbance on hospital day 3. This rare case underscores the need to consider opportunistic infections, such as mucormycosis, in immunocompromised patients exhibiting neurological symptoms post-influenza. Early identification and antifungal treatment are crucial for improving outcomes in similar cases. Advanced diagnostic techniques may enhance the detection and management of such infections."

Case report • Clinical • Cardiovascular • CNS Disorders • Diabetes • Hematological Disorders • Hematological Malignancies • Infectious Disease • Inflammation • Influenza • Ischemic stroke • Metabolic Disorders • Myelodysplastic Syndrome • Oncology • Pneumonia • Respiratory Diseases • Vasculitis • IL6

Native Capillary Nanogel Electrophoresis Assay of Inhibitors of Neuraminidases Derived from H1N1 and H5N1 Influenza A Pandemics. (PubMed, Anal Chem) - "The inhibition constants for oseltamivir acid (inhibiting compound of Tamiflu) and peramivir (Rapivab) are 18.2 ± 0.5 nM (n = 3) and 67 ± 8 nM (n = 3), respectively. For 2004 H5N1 (A/Vietnam/1203/2004) neuraminidase, which contained a foreign tetramerization domain to maintain the structure, the inhibition constant for peramivir is 5.4 nM."

Journal • Infectious Disease • Influenza • Respiratory Diseases

In Vitro and In Vivo Assessment of Pharmacokinetic Profile of Peramivir in the Context of Inhalation Therapy. (PubMed, Pharmaceuticals (Basel)) - "A preclinical pharmacokinetic platform applicable to inhaled medications was established. Inhalation of peramivir augments exposure at the target site while diminishing systemic exposure, presenting potential therapeutic benefits in terms of efficacy and safety and suggesting it as a favorable alternative administration pathway."

Journal • PK/PD data • Preclinical • Infectious Disease • Influenza • Respiratory Diseases

Effectiveness of Antiviral Treatment with Intravenous Peramivir and Oral Oseltamivir for Seasonal Influenza in Children. (PubMed, Children (Basel)) - "Peramivir presents as an effective alternative treatment for influenza in children, particularly in situations where oral administration is not feasible due to gastrointestinal intolerance, highlighting the importance of an alternative route of antiviral administration."

Journal • CNS Disorders • Epilepsy • Gastrointestinal Disorder • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

Antiviral Medications for Treatment of Nonsevere Influenza: A Systematic Review and Network Meta-Analysis. (PubMed, JAMA Intern Med) - "All antiviral drugs (no data for peramivir and amantadine) had little or no effect on hospital admission for low-risk patients (high certainty)...For time to alleviation of symptoms, baloxavir probably reduced symptom duration (mean difference [MD], -1.02 days; 95% CI, -1.41 to -0.63; moderate certainty); umifenovir may have reduced symptom duration (MD, -1.10 days; 95% CI, -1.57 to -0.63; low certainty); oseltamivir probably had no important effect (MD, -0.75 days; 95% CI, -0.93 to -0.57; moderate certainty)...This systematic review and meta-analysis found that baloxavir probably reduced risk of hospital admission for high-risk patients and may reduce time to alleviation of symptoms, without increasing adverse events related to treatment in patients with nonsevere influenza. All other antiviral drugs either probably have little or no effect, or uncertain effects on patient-important outcomes."

Clinical • Journal • Retrospective data • Critical care • Infectious Disease • Influenza • Respiratory Diseases

Influenza and Aging: Clinical Manifestations, Complications, and Treatment Approaches in Older Adults. (PubMed, Drugs Aging) - "Treatment primarily involves antiviral agents, such as oseltamivir and peramivir, with the greatest benefit observed when initiated early. Management of severe cases may require hospitalization and supportive care, including addressing complications, such as secondary bacterial infections and cardiovascular events. This article highlights the need for improved vaccination strategies and novel treatments, including monoclonal antibodies and adoptive T cell therapies, to better manage severe influenza infections in vulnerable populations such as older."

Journal • Review • Acute Respiratory Distress Syndrome • Cardiovascular • Infectious Disease • Influenza • Pneumonia • Pulmonary Disease • Respiratory Diseases

In vitro neuraminidase inhibitory concentrations (IC50) of four neuraminidase inhibitors in the Japanese 2023-24 season: Comparison with the 2010-11 to 2022-23 seasons. (PubMed, J Infect Chemother) - "These results indicate that susceptibility to these four NAIs has been maintained across the three influenza types/subtypes over the past fourteen seasons in Japan."

Journal • Preclinical • Infectious Disease • Influenza • Respiratory Diseases

Pharmacologic background and clinical issue of anti-influenza drugs. (PubMed, Fukushima J Med Sci) - "Since 2000, rapid antigen detection kits and anti-influenza drugs have been used for the early diagnosis and treatment of influenza in Japan, respectively.　The main drugs available in clinical practice are the neuraminidase inhibitors oseltamivir, zanamivir, laninamivir, and peramivir, as well as the cap-dependent endonuclease inhibitor baloxavir marboxil.　Antiviral therapy with neuraminidase inhibitors has been practiced for many years, especially in Japan; it can shorten the febrile period and reduce complications.　Despite having similar structures, the pharmacologic background of neuraminidase inhibitors differs significantly, as reflected in their varying clinical efficacy.　Due to its inhibitory mechanism, baloxavir marboxil can rapidly reduce the viral load than neuraminidase inhibitors.　However, the duration of symptoms was similar after the administration of baloxavir marboxil and oseltamivir, and variants with reduced drug susceptibility have been detected in..."

Journal • Infectious Disease • Influenza • Pediatrics • Respiratory Diseases

An outbreak of influenza A(H1N1)pdm09 antigenic variants exhibiting cross-resistance to oseltamivir and peramivir in an elementary school in Japan, September 2024. (PubMed, Euro Surveill) - "Antigenic analysis revealed differences from the vaccine strain. Continued monitoring is crucial to assess the potential for further spread of these mutant viruses."

Journal • Infectious Disease • Influenza • Respiratory Diseases

In hospitalized patients with influenza, oseltamivir or peramivir may reduce hospital length of stay (low-certainty evidence). (PubMed, Ann Intern Med) - "2024;404:753-763. 39181595."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Antiviral drug development by targeting RNA binding site, oligomerization and nuclear export of influenza nucleoprotein. (PubMed, Int J Biol Macromol) - "Current antiviral drugs such as oseltamivir, zanamivir, peramivir and baloxavir marboxil along with seasonal vaccines have limitations due to viral variability caused by antigenic drift and shift as well as the development of drug resistance...We discuss various strategies for targeting NP, including RNA binding, oligomerization, and nuclear export, and also consider the potential of NP-based vaccines. Overall, this review provides insights into recent developments and future perspectives on targeting influenza NP for antiviral therapies."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases

Update and narrative review of avian influenza (H5N1) infection in adult patients. (PubMed, Pharmacotherapy) - "This includes a cell-based vaccine approved by the FDA for people aged 6 months and older who are at higher risk of exposure to the H5N1 virus called Audenz...Neuraminidase inhibitors are the mainstay of the avian influenza treatment and includes oseltamivir, peramivir, and zanamivir. Baloxavir marboxil is a cap-dependent endonuclease inhibitor. This clinical review aims to highlight the background, epidemiology, clinical presentation, complications and current treatment and prevention strategies for avian influenza H5N1."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases

Occurrence and environmental fate of anti-influenza drugs in a subcatchment of the Yodo River Basin, Japan. (PubMed, Sci Total Environ) - "In this study, the behaviour of the prodrug baloxavir marboxil (BALM)-the active ingredient of Xofluza, an increasingly popular anti-influenza drug-and its pharmacologically active metabolite baloxavir (BAL) in the aquatic environment was evaluated. Additionally, their presence in urban rivers and a wastewater treatment plant (WWTP) in the Yodo River basin was investigated and compared with those of the major anti-influenza drugs used to date (favipiravir (FAV), peramivir (PER), laninamivir (LAN), and its active metabolite, laninamivir octanoate (LANO), oseltamivir (OSE), and its active metabolite, oseltamivir carboxylate (OSEC), and zanamivir (ZAN)) to comprehensively assess their environmental fate in the aquatic environment...Notably, all anti-influenza drugs were effectively removed by ozonation (>90-99.9 % removal) after biological treatment at a WWTP. Thus, these findings suggest the importance of introducing ozonation to reduce pollution loads in rivers and the..."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Influenza vaccine for 2024-2025. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Hepatitis B • Infectious Disease • Influenza • Respiratory Diseases • Respiratory Syncytial Virus Infections

Whole-Genome Analysis of the Influenza A(H1N1)pdm09 Viruses Isolated from Influenza-like Illness Outpatients in Myanmar and Community-Acquired Oseltamivir-Resistant Strains Present from 2015 to 2019. (PubMed, Viruses) - "These viruses exhibited highly reduced susceptibility to oseltamivir and peramivir. This study demonstrates the importance of monitoring genetic variations in influenza viruses that will contribute to the selection of global influenza vaccines."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Antivirals for treatment of severe influenza: a systematic review and network meta-analysis of randomised controlled trials. (PubMed, Lancet) - "In hospitalised patients with severe influenza, oseltamivir and peramivir might reduce duration of hospitalisation compared with standard care or placebo, although the certainty of evidence is low. The effects of all antivirals on mortality and other important patient outcomes are very uncertain due to scarce data from randomised controlled trials."

Clinical • Journal • Retrospective data • Review • Critical care • Infectious Disease • Influenza • Respiratory Diseases

Characteristics and outcome of influenza-associated encephalopathy/encephalitis among children in China. (PubMed, Clinics (Sao Paulo)) - "Children with IAE have a high mortality rate. Lower Glasgow coma score, longer duration of fever, with underlying medical conditions and complications pose a great risk to poor prognosis. Influenza vaccination is recommended to all eligible children."

Journal • Retrospective data • Acute Kidney Injury • CNS Disorders • Hematological Disorders • Infectious Disease • Influenza • Pediatrics • Renal Disease • Respiratory Diseases • Septic Shock

Antiviral susceptibility of SARS-CoV-2 and influenza viruses from 3 co-infected pediatric patients. (PubMed, Int J Infect Dis) - "We evaluated the susceptibility of SARS-CoV-2 against RNA-dependent RNA polymerase inhibitors (remdesivir and molnupiravir) and 3C-like protease inhibitors (nirmatrelvir and ensitrelvir), and that of influenza viruses against neuraminidase inhibitors (oseltamivir, peramivir, zanamivir, and laninamivir) and the cap-dependent endonuclease inhibitor baloxavir...The patients were treated with anti-influenza drugs and did not develop severe symptoms despite the co-infection. Since SARS-CoV-2 and influenza viruses continue to evolve, continuous monitoring of their circulation remains essential to assess public health measures and support clinical management."

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

Treating influenza with neuraminidase inhibitors: an update of the literature. (PubMed, Expert Opin Pharmacother) - "While the prevalence of influenza virus resistance to NAIs remains low, there is heightened vigilance due to the pandemic potential of influenza. Several novel NAIs and derivatives are currently under assessment at various stages of development for the treatment and prevention of influenza."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases