Polymerase basic protein 2 (PB2) (influenza virus) inhibitor Treatment of influenza A infection

Pimodivir (VX-787, JNJ-63623872) is an investigational anti-influenza drug, currently undergoing clinical development. Pimodivir is a non-nucleoside analogue that targets the cap-binding activity of the influenza A virus PB2 polymerase subunit. It is potent against influenza A, including against adamantanes and neuraminidase inhibitor-resistant strains. In a phase IIb study of naturally acquired influenza A virus infection, a statistically significant and dose-dependent decrease in virus load was observed. Diarrhea was the most common adverse event reported and was typically mild. Pimodivir is a substrate for CYP3A4 metabolism but itself has no inhibitory or induction effects on the isoenzyme. It is also a substrate for P-glycoprotein and OATP1B1 and also inhibits P-glycoprotein. Specific drug interactions have not yet been studied. Pimodivir 600 mg twice daily for 5 days has been selected and is undergoing further evaluation in phase III clinical trials.