zanamivir with methylprednisolone anew hope for swin flu

1st inhaled antiviral drug


in the form of i.v injection together with metylprednizolone can be anew hope for swin flu






LONDON (Reuters) Sep 04 - Physicians from the UK have saved the life of
a patient with severe H1N1 swine flu by treating her with an unlicensed
intravenous form of the drug zanamivir (Relenza; GlaxoSmithKline),
according to a report published online Friday in The Lancet.

Zanamivir is currently only approved as an inhaled medicine. This
version, however, did not work in the 22-year-old woman, who was
neutropenic after recent chemotherapy for Hodgkin's disease.

"Since her inflamed, atelectatic lungs were probably impeding adequate
drug absorption, and clinical improvement was not forthcoming, we
decided to use intravenous (unlicensed) zanamivir. High dosing achieves
effective respiratory epithelial concentrations and is well-tolerated,"
Dr. I. Michael Kidd from University College London Hospitals and
colleagues explain in the report.

The patient also did not respond to oral oseltamivir (Tamiflu; Roche) or broad-spectrum antimicrobials.

Dr. Kidd and colleagues treated the patient with intravenous zanamivir
in combination with high-dose corticosteroids and her condition
improved within 48 hours.

Intravenous zanamivir was started on ICU day 16 and by ICU day 21, H1N1
viral load had decreased over 100-fold, they report, adding: "Our
patient progressively recovered with no drug-related side effects."

"Although this is a single case report and direct cause and effect
cannot be confirmed, the improvement in clinical status following
intravenous zanamivir encourages prompt further investigation, both
alone and in combination with high-dose methylprednisolone," Dr. Kidd
and colleagues note.

H1N1 influenza was declared a pandemic in June and has been spreading globally since then.

Other flu drugs are under development to deal with seasonal and
pandemic influenza. One that has shown promise in intravenous form is
BioCryst Pharmaceuticals' experimental product peramivir.




Lancet 2009