アブストラクト
Japanese
| Title | インフルエンザ治療薬の進歩 |
|---|---|
| Subtitle | 特集 コロナ禍でのインフルエンザ |
| Authors | 佐藤晶論 |
| Authors (kana) | |
| Organization | 福島県立医科大学 医学部 小児科学講座 |
| Journal | 臨床とウイルス |
| Volume | 50 |
| Number | 5 |
| Page | 289-298 |
| Year/Month | 2022 / 12 |
| Article | 報告 |
| Publisher | 日本臨床ウイルス学会 |
| Abstract | 〔論文要旨〕 2000年以降, 日本におけるインフルエンザ診療では, 迅速抗原検出キットを活用した早期診断と抗インフルエンザ薬による早期治療が実践されている. 主としてノイラミニダーゼ阻害薬であるオセルタミビル, ザナミビル, ラニナミビル, ペラミビル, キャップ依存性エンドヌクレアーゼ阻害薬であるバロキサビルが臨床の現場で投与可能である. 各ノイラミニダーゼ阻害薬の構造は類似しているが, 薬物動態は大きく異なっており, これが各薬剤間の臨床効果の差として反映される場合もある. バロキサビルについては, その阻害機序からノイラミニダーゼ阻害薬と比較し投与早期にウイルス量を減少させることができる. 単回の経口内服で治療が完結するため, 服薬アドヒアランスが高い薬剤であるが, オセルタミビルとの比較では有症状期間は同等であり, 小児では投与した患者の20〜30%で薬剤低感受性ウイルスが検出されるなど, 課題も指摘されている. 現在, 複数の新規抗インフルエンザ薬の臨床試験が進められており, 今後, これらの薬剤が上市された場合, インフルエンザウイルスそのものの特性, 薬物の薬理学的背景を整理し, 実際の患者に投与することが求められる. |
| Practice | 臨床医学：内科系 |
| Keywords | インフルエンザ, 抗インフルエンザ薬, ノイラミニダーゼ阻害薬, キャップ依存性エンドヌクレアーゼ阻害薬, influenza, anti-influenza drugs, neuraminidase inhibitors, cap-dependent endonuclease inhibitor |
English
| Title | Advances in anti-influenza therapeutics |
|---|---|
| Subtitle | |
| Authors | Masatoki SATO |
| Authors (kana) | |
| Organization | Department of Pediatrics, Fukushima Medical University |
| Journal | Clinical Virology |
| Volume | 50 |
| Number | 5 |
| Page | 289-298 |
| Year/Month | 2022 / 12 |
| Article | Report |
| Publisher | Japanese Society of Clinical Virology |
| Abstract | Anti-influenza drugs approved for production in Japan include an M2 channel inhibitor (amantadine); neuraminidase (NA) inhibitors (oral oseltamivir, inhaled zanamivir and laninamivir, and intravenously administrated peramivir); and RNA polymerase inhibitors (favipiravir and baloxavir marboxil). However, because all influenza viruses isolated are resistant to amantadine, this drug is currently not administered to patients in clinical practice. NA inhibitors inhibit the release of the replicated progeny of the virus inside the host cell to the extracellular space. Although the chemical structures of different NA inhibitors are similar, the route of administration and drug pharmacokinetics are very different, which can lead to differences in clinical efficacy among the drugs. Favipiravir exerts its antiviral efficacy by being incorporated as a nucleic acid analog during the elongation of messenger RNA and inhibiting viral protein synthesis. Baloxavir reduces viral protein synthesis by inhibiting the activity of cap-dependent endonuclease on the influenza viral RNA polymerase PA subunit, which is required during transcription of messenger RNA. Although baloxavir has high drug adherence because treatment is completed with a single oral dose, some issues, such as the detection of reduced-susceptibility variants among 20-30% of pediatric patients treated, need to be addressed. Clinical trials of several novel anti-influenza drugs are currently underway. Once these drugs are introduced into the clinical setting, the characteristics of the influenza virus itself and the pharmacological background of the drugs must be investigated fully before they are administered to patients. |
| Practice | Clinical internal medicine |
| Keywords | influenza, anti-influenza drugs, neuraminidase inhibitors, cap-dependent endonuclease inhibitor |
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