Viramidine (Valeant Pharmaceuticals), a ribavirin prodrug for the improved treatment of hepatitis C (HCV) infection
Summary
Hepatitis C virus (HCV) infection produces cirrhosis, end-stage liver disease and liver cancer and by 2010 38,000 deaths will result from infection. Anemia associated with ribavirin, a common treatment of infected patients represents a major problem. Valeant Pharmaceutical have developed a prodrug of ribavirin, viramidine which is activated within the liver resulting in reduced levels of ribavirin accumulating in red blood cells thus overcoming the problem of anemia.Hepatitis C virus (HCV) infection produces cirrhosis, end-stage liver disease and liver cancer and by 2010 38,000 deaths will result from infection. The current standard of care for chronic HCV infection is a combination of an interferon-alpha product and ribavirin however under-use of available treatments as well as anemia associated with ribavirin represents a serious problem (for further information see our feature "Pipeline Insight: Hepatitis C"). Even so, worldwide sales of ribavirin totalled approximately $1.2 billion in 2002. Opportunities for prodrugs of ribavirin are immense both in terms of patient care and pharmaceutical revenue. Valeant have developed a prodrug of ribavirin, viramidine which is activated within the liver resulting in reduced levels of ribavirin accumulating in red blood cells. The present phase I study of viramidine demonstrates the excellent absorption and activation of oral viramidine. Although treatment with viramidine resulted in the accumulation of ribavirin in the plasma and red blood cells viramidine displayed good tolerability and infrequent hemolysis. Since a phase II study has been successfully completed demonstrating reduced anemia but equal efficacy with viramidine compared to ribavirin and phase III studies have now been initiated...[more]
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