Pleconaril, a Novel Antipicornaviral Agent

Naomi R. Florea, Pharm.D., Dana Maglio, Pharm.D., David P. Nicolau, Pharm.D., FCCP


Pharmacotherapy. 2003;23(3) 

In This Article

Abstract and Introduction

Despite the availability of therapy for selected symptoms, no specific antiviral agents are available to treat or prevent infections due to the viruses of the Picornaviridae family -- rhinoviruses and enteroviruses. Characterization of the three-dimensional structure of picornaviruses in the 1980s allowed development of compounds targeted at the virus itself. Pleconaril is a novel, orally available, systemically acting molecule whose pharmacokinetics are characterized by a two-compartment open model with first-order absorption and with a safety profile similar to that of placebo. It shows promising results in treatment of picornaviral respiratory tract infections, meningitis, and other life-threatening infections.

The most common viruses implicated in respiratory infections, and among the most prevalent and clinically important viral pathogens infecting humans, are those of the Picornaviridae family -- rhinoviruses and enteroviruses. In the United States alone there are over 1 billion colds annually,[1] of which rhinoviruses are the leading cause. Certain patients are at risk for complications due to the common cold, such as those with asthma, chronic heart failure, bronchiectasis, and cystic fibrosis. Rhinoviruses are also a predominant cause of asthma exacerbations in adults and children[2,3] and severe lower respiratory tract disease, including acute exacerbations of chronic bronchitis. Enteroviruses are the most common cause of viral meningitis in the United States and an important cause of encephalitis, poliomyelitis, myocarditis, hemorrhagic conjunctivitis, hand-foot-mouth syndrome, pleurodynia, and non-specific febrile illnesses.[4,5] They cause approximately 10-15 million infections annually.[6] They are important pathogens in central nervous system (CNS) infections and target a variety of other organ systems as well.

Treatment for these viral infections is limited to symptomatic remedies. Elucidation of the structure of picornaviruses in 1985 provided the means to identify a potential target for specific antiviral pharmacologic therapy. Pleconaril is the most advanced antipicornaviral compound developed thus far and is being studied in clinical trials for treatment of various infectious diseases due to rhinoviruses and enteroviruses.