Relenza (zanamivir) / GSK, Vaxart - LARVOL DELTA

Emergence and spread of NA-I223V and NA-S247N double-mutant A(H1N1)pdm09 influenza viruses with reduced oseltamivir susceptibility in the Netherlands and beyond, 2023 to 2026. (PubMed, Euro Surveill) - "Dutch double mutants from both seasons showed median 12- and 13-fold reduced inhibition by oseltamivir. These findings underscore the need for ongoing genomic and phenotypic monitoring of antiviral susceptibility."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Stable simulations do not guarantee functional engagement: a case study of off-target prediction for Seladelpar and Zanamivir. (PubMed, J Comput Aided Mol Des) - "Where experimental drug-bound structures existed, AlphaFold3 reproduced the pose for PPARα but not PPARγ, and its per-model confidence did not track pose accuracy. Within this case study, the specific global descriptors examined reflect complex stability rather than functional engagement, which does not mean MD-based approaches cannot make this distinction."

Journal • Infectious Disease • Influenza • Respiratory Diseases • PPARA

Mathematical quantification of binding complementarity using intersection surface area (ISA) and geometric sensitivity index (GSI). (PubMed, J Comput Aided Mol Des) - "Notably, Zanamivir (Ligand D) exhibited the highest geometric sensitivity with a 27.2% reduction in [Formula: see text], providing a structural rationale for its observed clinical susceptibility patterns. This integrated geometric-MD approach offers an indicative screening framework for evaluating next-generation neuraminidase inhibitors against emerging viral mutants."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Report on influenza viruses received and tested by the Melbourne WHO Collaborating Centre for Reference and Research on Influenza during 2025. (PubMed, Commun Dis Intell (2018)) - "Of 3,307 samples tested for susceptibility to the neuraminidase inhibitors oseltamivir and zanamivir, 37 A(H1N1)pdm09 viruses showed highly reduced inhibition by oseltamivir and no influenza viruses tested showed highly reduced inhibition by zanamivir. Of 5,080 samples with sequencing of the polymerase acidic (PA) gene, no genetic markers associated with highly reduced susceptibility to baloxavir marboxil were identified."

Journal • Infectious Disease • Influenza • Respiratory Diseases

FDA approved drug containing acetamide group- a mini review. (PubMed, Front Chem) - "In this article we mainly focus on synthesis, biological activity and mechanism of action of acetamido containing FDA approved drugs. This article aims to highlight the versatility and continued relevance of acetamido as a key functional group in the discovery and optimization of modern pharmaceuticals."

FDA event • Journal • Review • Oncology

In silico study: ADMET-driven pharmacokinetic profiling of antiviral compounds for pre-clinical screening framework of intranasal drug development. (PubMed, J Pharmacol Toxicol Methods) - "This study employed computational ADMET Predictor tools to systematically evaluate the physicochemical and potential pharmacokinetic properties of ten reference compounds, including nine approved antiviral drugs and ivermectin, a repurposed antiparasitic agent with reported antiviral activity and prior intranasal investigation: Zanamivir, Ribavirin, Oseltamivir, Favipiravir, Remdesivir, Nitazoxanide, Acyclovir, Lopinavir, Molnupiravir, and Ivermectin...The analysis resulted in revised criteria including molecular weight (Mwt), pH, lipophilicity (Log P), water solubility (Sw and SpH), Volume of distribution (Vd), P-glycoproteins substrate (Pgp substrate), and skin sensitization (Sens_Skin) to demonstrate 80% concordance with approved drug properties. This framework provides the preliminary evidence-based screening criteria as a tool to identify promising drug candidates suitable for preclinical evaluation in intranasal formulation development."

Journal • PK/PD data • Preclinical • Developmental Disorders • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections

Antiviral Dispensing for Influenza Outpatients Younger Than 65 Years With Comorbidities: A Retrospective Cohort Study. (PubMed, Open Forum Infect Dis) - "Antiviral treatment was defined as dispensing of oseltamivir, peramivir, zanamivir, or baloxavir within 7 days of the encounter...About half of higher-risk influenza outpatients received antivirals. Overall dispensing was similar by insurance type, but Medicaid patients and those with multiple UMCs had greater delays."

Journal • Retrospective data • Infectious Disease • Influenza • Pulmonary Disease • Respiratory Diseases

Characterization of oseltamivir-resistant A(H5N1) clade 2.3.4.4b, genotype D1.1 variants identified in poultry farms of British Columbia, Canada. (PubMed, Emerg Microbes Infect) - "Neuraminidase inhibitor (NAI) susceptibility was determined by NA inhibition assays, whereas susceptibility to baloxavir acid (BXA) was evaluated by plaque reduction assay...Viral titers in lungs, brain, nose, kidney, spleen, and heart were quantified at day 4 p.i. The BC-H5N1-WT virus was susceptible to the four antivirals tested, whereas BC-H5N1-H275Y displayed resistance to oseltamivir and peramivir but remained susceptible to zanamivir and BXA...In mice, BC-H5N1-WT was more virulent with LD50 values of 1.78 × 103 PFUs compared to 8.71 × 104 PFUs for BC-H5N1-H275Y, and produced higher viral titers in lungs and other organs. Despite the reduced fitness of the resistant H5N1 D1.1 variant, its emergence in the absence of viral selection pressure underscores the need for continued surveillance."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Influenza Antiviral Prescriptions in the US Inpatient and Outpatient Settings During the 2015-2022 Influenza Seasons. (PubMed, Influenza Other Respir Viruses) - "Among US insured individuals, oseltamivir remained the most prescribed antiviral during the 2016-2017 through 2022-2023 seasons, a pattern consistent with its broader FDA-approved indication across age groups and care settings relative to baloxavir, peramivir, and zanamivir."

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

Signal mining of adverse reactions for neuraminidase inhibitors in pregnant women: a disproportionality analysis based on the FDA adverse event reporting system database. (PubMed, Front Med (Lausanne)) - "From Q1 2004 to Q3 2025, a total of 3,687 ADE reports were retrieved in this study, including 3,211 reports for oseltamivir, 471 reports for zanamivir, and 5 reports for peramivir...The study findings align with current guidelines recommending neuraminidase inhibitors as the primary antiviral treatment of pregnant women with influenza. Our study may offer valuable evidence to support the clinical use of neuraminidase inhibitors, particularly in identifying adverse events and ensuring their safe administration in women during pregnancy."

Adverse events • Journal • Acne Vulgaris • Gastrointestinal Disorder • Infectious Disease • Influenza • Perinatal Disorders • Respiratory Diseases

Antivirals Improve Outcomes in Influenza. (PubMed, Emerg Med Clin North Am) - "Antivirals like neuramidase inhibitors (oseltamivir, zanamivir, and peramivir) and endonuclease inhibitors (baloxavir) can help with treatment when started within 48 hours of symptom onset, primarily shortening illness duration by about 1 day...elerly, pregnant and immunocompromized). However, for healthy, low-risk outpatients, the clinical benefit is modest, adn the risk of side effects is high."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases

Critical updates in the 2024 influenza clinical practice guidelines of the World Health Organization. (PubMed, Infect Dis Immun) - "Baloxavir is not recommended for non-severe cases without severe risk factors, and other antivirals like oseltamivir, laninamivir, peramivir, zanamivir, favipiravir, and arbidol are not recommended for non-severe patients...Resource availability and co-infections can influence guideline implementation. Further research is needed to identify optimal strategies for specific populations."

Clinical guideline • Journal • Infectious Disease • Influenza • Obesity • Respiratory Diseases

Fragment Molecular Orbital Calculation Analysis of Influenza Neuraminidase and Inhibitor Interactions (PubMed, Yakugaku Zasshi) - "The interactions between four compounds used as influenza neuraminidase inhibitors-oseltamivir, zanamivir, laninamivir, and peramivir- and influenza virus neuraminidase were analyzed using pair interaction energy decomposition analysis based on fragment molecular orbital (FMO) method, quantitatively elucidating binding characteristics of each inhibitor. Our calculations revealed that structures with common functional groups showed similar binding characteristics, whereas structures with functional groups differing in hydrophilicity/hydrophobicity showed different types of intermolecular interactions for the same amino acid residues. Such analysis is expected to be effective for precise molecular design in structure-based drug design."

Journal • Infectious Disease • Influenza • Respiratory Diseases

ACUTE LEUKOENCEPHALOPATHY AND MYOPERICARDITIS ASSOCIATED WITH INFLUENZA A H3 INFECTION IN A CHILD (ESPID 2026) - "Initial treatment comprised ceftriaxone, gentamicin, oseltamivir, and hydrocortisone...Limited data suggest that early use of tocilizumab, an IL-6 receptor antagonist, is safe and may be effective in IAE. This case highlights the potential role of targeted immunomodulation and reinforces the importance of influenza vaccination in young children to reduce the risk of severe disease."

Clinical • Infectious Disease • Influenza • CRP • IL6

ARE WE TREATING ENOUGH? ASSESSING EFFECTS OF AMERICAN ACADEMY OF PEDIATRICS GUIDELINES ON OUTPATIENT ANTIVIRAL USE AMONG COMMERCIALLY INSURED CHILDREN IN THE UNITED STATES, 2016-2023. (ESPID 2026) - "Oseltamivir (99.15%) was most frequently prescribed, followed by baloxavir (0.83%) and zanamivir (0.01%). Dispensing rates remain unchanged from 17.06 to 15.27 per 1000 children from 2016 to 2023 (p=0.695) across all ages, especially among 0-11 months agegroup (p=0.908). Conclusions/Learning Points Although there is variability in use of antiviral by clinical conditions, no significant changes were noted in antiviral use for reducing influenza-associated complications in children aged 0-17 years."

Clinical • Infectious Disease • Influenza

In vitro efficacy of anti-influenza active compounds against clinical isolates with high growth capability. (PubMed, Arch Virol) - "In the present study, five anti-influenza agents-including four neuraminidase inhibitors (zanamivir, laninamivir, peramivir, and oseltamivir acid) and one polymerase acidic endonuclease inhibitor (baloxavir acid)-were evaluated against both a laboratory strain (PR8) and four clinical isolates lacking known resistance mutations...Effectiveness varies by the epidemic strains, likely due to unknown genetic factors. Further research is needed to identify these traits and improve diagnosis and treatment."

Journal • Preclinical • Infectious Disease • Influenza • Respiratory Diseases

Therapeutic effects of zanamivir against L-NAME-induced preeclampsia in mice and network pharmacology analysis. (PubMed, Eur J Pharmacol) - "PPI network and clustering, GO annotation, pathway and organ system & cell-type enrichment analysis also supported that regulation of blood pressure was the core biological action of zanamivir in treating preeclampsia. Taken together, the in vivo and in silico findings demonstrated the therapeutic effects of zanamivir against preeclampsia, particularly the regulation of hypertension, the importance of restoring glycocalyx integrity and endothelial function, and the potential of targeting neuraminidase when seeking novel therapies for preeclampsia."

Journal • Preclinical • Cardiovascular • Gynecology • Hypertension • Renal Disease

INAAC: An affinity chromatography strategy enabling characterization and quantification of influenza neuraminidase antigens in vaccines. (PubMed, J Biol Chem) - "Finally, comparative analyses of NAs isolated from recent egg-propagated vaccine strains (H1N1, H3N2 and type B) revealed a unique proteolytic susceptibility of type B NA and strain-specific differences in sialic acid affinities and catalytic rates. These results demonstrate that INAAC supports multiple applications from NA structural analysis to producing NA vaccine antigens and reference standards, addressing longstanding challenges for incorporating NA into influenza vaccine development and quality control."

Journal • 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

Use of animal efficacy, pharmacokinetic/pharmacodynamic and first in human data for regulatory approval of treatment options against chemical, biological, radiological and nuclear threats. (PubMed, Philos Trans R Soc Lond B Biol Sci) - "Challenges and advantages of this approach are highlighted, including the lessons learned based on the examples of tecovirimat, zanamivir and obiltoxaximab. This article is part of the Theo Murphy meeting issue 'Evaluating anti-infective drugs'."

First-in-human • Journal • P1 data • PK/PD data • Review

Association of severe abnormal behavior of influenza patients and administered anti-influenza virus drugs: 2006-2022. (PubMed, Int J Infect Dis) - "Findings indicate that oseltamivir alone does not raise risks of abnormal behavior among influenza patients."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Association of antiviral use for influenza among non-severe cases with subsequent hospitalization and mortality. (PubMed, BMC Med) - "Antiviral treatment was negatively associated with hospitalization, ICU admission, and mortality. The results need to be interpreted with caution, given limitations."

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

Influenza Virus Neuraminidase Glycoprotein, Its Inhibitors, and Their Resistance. (PubMed, Adv Exp Med Biol) - "This chapter provides an overview of the structure and function of NA and of four NA inhibitors-zanamivir, oseltamivir, peramivir, and laninamivir-that are widely used for the treatment and prophylaxis of influenza A and B viral infections. The importance of monitoring the emergence and global spread of NA inhibitor-resistant viruses is also discussed."

Journal • Review • Infectious Disease • Influenza • Respiratory Diseases

Metabolism and excretion pathways of CD388, a novel drug-fragment crystallizable conjugate for prevention of seasonal or pandemic influenza. (PubMed, Drug Metab Dispos) - "Intact CD388 is not cleared renally, improving half-life and the potential for single CD388 administration to provide seasonal influenza protection. Additionally, the minimal metabolism of CD388 make the potential for metabolic drug interactions low."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Epidemiology of influenza A and B viruses in Mauritius over an 8-year period, 2009-2016. (PubMed, Virology) - "Mauritius exhibits year-round circulation of influenza viruses with ongoing antigenic drift, supporting the need for continued influenza surveillance."

Journal • Infectious Disease • Influenza • Respiratory Diseases