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Could intravenous antivirals be a last-ditch treatment for swine flu?

September 3, 2009 |  5:41 pm

PigAn unlicensed intravenous form of the antiviral drug Relenza saved the life of a woman with a severe illness resulting from infection by the pandemic H1N1 influenza virus, British doctors reported today in the journal Lancet. Dr. Michael Kidd and Dr. Mervyn Singer of the University College London Hospitals were treating the virus, commonly known as swine flu, in a 22-year-old woman who had contracted it after undergoing chemotherapy for Hodgkin's disease.

The woman had increasing shortness of breath, build-up of fluid in both lungs and was progressively deteriorating. Physicians had given her Tamiflu and Relenza, which is normally given in an inhalable form. Neither was effective, and on the 16th day of her stay in the intensive care unit, the doctors decided to try an experimental form of Relenza that is given intravenously. Permission for the experiment was given by the hospital and the woman's relatives, and the drug was supplied by the manufacturer, GlaxoSmithKline. Her condition improved within 48 hours and she was discharged from the ICU on the 24th day. The doctors speculated that neither the inhaled Relenza nor the oral Tamiflu were reaching the infection deep in her lungs.

Both GlaxoSmithKline and Roche, which manufactures Tamiflu, have been testing intravenous formulations of the drugs with some success. Additionally, BioCryst Pharmaceuticals of Birmingham, Ala, has been testing a third antiviral drug called peramivir, primarily in Japan. The President's Council of Advisors on Science and Technology, in a report presented to the White House last week, called on the Food and Drug Administration to accelerate the approval process for the drugs, and many doctors have echoed that call, terming the intravenous drugs a valuable new addition to therapy of influenza infections.

-- Thomas H. Maugh II

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