Closing in On Effective Treatment for RSV Virus Infections

John DeVincenzo, M.D. Professor of Pediatrics Division of Infectious Diseases Professor of Microbiology, Immunology and Biochemistry University of Tennessee School of Medicine. University of Tennessee. Medical Director, Molecular Diagnostics and Virology Laboratories Le Bonheur Children's Hospital Memphis, TennesseeMedicalResearch.com Interview with:
John DeVincenzo, M.D.
Professor of Pediatrics
Division of Infectious Diseases
Professor of Microbiology, Immunology and Biochemistry
University of Tennessee School of Medicine.
Le Bonheur Children’s Hospital Memphis, Tennessee

Medical Research: What are the main findings of the study?

Dr. DeVincenzo: The main findings are

  • a) This is the first time that anyone has shown that the infection caused by the RSV virus can be effectively reduced in a human after the infection has already started.
  •  b) We also show for the first time that once we reduce the amount of virus in the patient, that very quickly, they start to feel better. This clinical improvement was not expected to occur so rapidly.
  • c) The antiviral appeared safe and it was easy to give.

Medical Research: Were any of the findings unexpected?

Dr. DeVincenzo: Yes, the findings were unexpected in that they were more robust than any of us in the field thought could occur.  It was previously thought that the RSV virus caused a human infection and then the infection triggered a very robust inflammatory response which caused the bulk of human disease.  Leading up to this study, I had been generating data that was putting this disease concept into greater and greater doubt, but this study really proves that the previous prevailing concept of how the virus causes disease is incorrect.  We show here in the paper that we can reduce the virus quickly and effectively after the virus infection has already started.  Concomitantly with this antiviral effect, we saw a very quick and profound reduction in the quantity of disease in the patients.  They had less symptoms and they had much less mucus production from their respiratory tracts.

Medical Research: What should clinicians and patients take away from your report?

Dr. DeVincenzo: Patients and clinicians should be aware that now we are close to having an effective therapy for RSV, the second leading cause of viral pneumonia in the world (behind influenza).

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. DeVincenzo: Future research should move this particular experimental antiviral therapeutic forward into populations which are at high risk of developing serious RSV infections (including children, immunocompromised patients, and the frail elderly and those with underlying cardiopulmonary conditions).

This study should greatly encourage other antivirals to be developed which could potentially target the virus in a different way.  But we have now established a proof of concept that RSV infection itself can be treated leading to reduced disease in humans.  So alternative antivirals should be evaluated which could have this same, or even greater effect.

Citation:

Oral GS-5806 Activity in a Respiratory Syncytial Virus Challenge Study

John P. DeVincenzo, M.D., Richard J. Whitley, M.D., Richard L. Mackman, Ph.D., Cecilia Scaglioni-Weinlich, M.D., Lisa Harrison, M.L.T., Eric Farrell, B.S., Stephen McBride, B.S., Robert Lambkin-Williams, Ph.D., Robert Jordan, Ph.D., Yan Xin, Ph.D., Srini Ramanathan, Ph.D., Thomas O’Riordan, M.D., Sandra A. Lewis, M.S., Xiaoming Li, Ph.D., Seth L. Toback, M.D., Shao-Lee Lin, M.D., Ph.D., and Jason W. Chien, M.D.

N Engl J Med 2014; 371:711-722
August 21, 2014DOI: 10.1056/NEJMoa1401184

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