, Volume 70, Issue 11, pp 1349–1362 | Cite as

Drugs in Development for Influenza

  • David A. BoltzEmail author
  • Jerry R. AldridgeJr
  • Robert G. Webster
  • Elena A. Govorkova
Leading Article


The emergence and global spread of the 2009 pandemic H1N1 influenza virus reminds us that we are limited in the strategies available to control influenza infection. Vaccines are the best option for the prophylaxis and control of a pandemic; however, the lag time between virus identification and vaccine distribution exceeds 6 months and concerns regarding vaccine safety are a growing issue leading to vaccination refusal. In the short-term, antiviral therapy is vital to control the spread of influenza. However, we are currently limited to four licensed anti-influenza drugs: the neuraminidase inhibitors oseltamivir and zanamivir, and the M2 ion-channel inhibitors amantadine and rimantadine. The value of neuraminidase inhibitors was clearly established during the initial phases of the 2009 pandemic when vaccines were not available, i.e. stockpiles of antivirals are valuable. Unfortunately, as drug-resistant variants continue to emerge naturally and through selective pressure applied by use of antiviral drugs, the efficacy of these drugs declines. Because we cannot predict the strain of influenza virus that will cause the next epidemic or pandemic, it is important that we develop novel anti-influenza drugs with broad reactivity against all strains and subtypes, and consider moving to multiple drug therapy in the future. In this article we review the experimental data on investigational antiviral agents undergoing clinical trials (parenteral zanamivir and peramivir, long-acting neuraminidase inhibitors and the polymerase inhibitor favipiravir [T-705]) and experimental antiviral agents that target either the virus (the haemagglutinin inhibitor cyanovirin-N and thiazolides) or the host (fusion protein inhibitors [DAS181], cyclo-oxygenase-2 inhibitors and peroxisome proliferator-activated receptor agonists).


Influenza Influenza Virus Oseltamivir Zanamivir Influenza Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Betsy Williford for the figure design and Vani Shanker, PhD, ELS for expert editorial review of the article. The authors’ laboratories are funded in part by the National Institute Allergy and Infectious Diseases, National Institutes of Health, under contract number HHSN 266200700005C and by the American Lebanese Syrian Associated Charities. JRA is funded by grant 1F32AI078667 by the National Institute Allergy and Infectious Diseases, National Institutes of Health. RGW and EAG receive research funding from Hoffmann-La Roche and BioCryst Pharmaceuticals.

This work was carried out while DAB was affiliated with St. Jude Children’s Hospital. His present affiliation is the Microbiology and Molecular Biology Division, IIT Research Institute, Chicago, IL, USA.


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Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • David A. Boltz
    • 1
    Email author
  • Jerry R. AldridgeJr
    • 1
  • Robert G. Webster
    • 1
  • Elena A. Govorkova
    • 1
  1. 1.Division of Virology, Department of Infectious DiseasesSt. Jude Children’s Research HospitalMemphisUSA

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