Home

Pleconaril meningitis

Background: In this patient group, chronic enteroviral meningitis (CEMA) is feared because of extensive morbidity and high fatality rate. Treatment options consist of intravenous immunoglobulin (IVIG), with various outcomes. Pleconaril is an antiviral agent with in vitro activity against HEVs that has been used in the treatment of HEV infections BACKGROUND: Enterovirus (EV) meningitis is common in infants and may have neurologic complications. Treatment of older children and adults with pleconaril has been associated with reduced severity and duration of symptoms. This study evaluated the pharmacokinetics, safety and efficacy of pleconaril in infants with EV meningitis enteroviral infections. Pleconaril is also able to cross the blood-brain barrier and target the viruses responsible for causing meningitis. Pleconaril is thought to be able to cross the blood-brain barrier because of its lipophilic character. Pleconaril has also been administered to over 1700 people and ha Pleconaril, an inhibitor of Enteroviral meningitis causes appreciable morbidity in adults, including hospitalization, decreased activity, and headache. Limited data define the natural history of disease. No antiviral therapeutic agent has demonstrated improved outcome in controlled clinical trials

Pleconaril revisited: clinical course of chronic

In a clinical trial in adolescents and adults with enterovirus meningitis, pleconaril elicited few serious adverse events and reduced the duration of headache when given within 2 days of onset [ 9 ] Enteroviral meningitis: Pleconaril appeared promising but drug was not FDA approved and no longer available for compassionate use. Given evidence of benefit from IV immunoglobulin (IVIG) if given early for severe EV 71 infection in Asia, now used routinely and part of treatment guidelines in Taiwan Clinical activity of pleconaril in an experimentally induced coxsackievirus A21 respiratory infection. et al. Aseptic meningitis in infants younger than 2 years of age: acute illness and. Viral meningitis, like acute bacterial meningitis, usually begins with symptoms that suggest viral infection (eg, fever, myalgias, gastrointestinal or respiratory symptoms), followed by symptoms and signs of meningitis (headache, fever, nuchal rigidity).Manifestations tend to resemble those of bacterial meningitis but are usually less severe (eg, nuchal rigidity may be less pronounced) In cases of viral meningitis it is not always possible to identify the type of virus responsible for the disease (approximately 30-40% of patients have no pathogen identified). Although HIV is a rare cause of viral meningitis, it is important that adults with viral meningitis due to unknown cause undergo an HIV test

Double blind placebo-controlled trial of pleconaril in

  1. Background. Enterovirus (EV) meningitis is common in infants and may have neurologic complications. Treatment of older children and adults with pleconaril has been associated with reduced severity and duration of symptoms. This study evaluated the pharmacokinetics, safety and efficacy of pleconaril in infants with EV meningitis.. Methods. Infants ≤12 months old with suspected EV meningitis.
  2. Pleconaril has been studied in trials involving numerous more commonly occurring picornavirus infections of healthy hosts, including large trials of the drug in cases of enterovirus meningitis in adults and children and in cases of viral respiratory infection (primarily with rhinoviruses) in adults . In these studies, pleconaril has also been.
  3. In addition to the medications listed below, pleconaril is an experimental agent that interferes with attachment, entry, and uncoating of enteroviruses. It was shown to be well tolerated by neonates in a single, small, double-blinded study
  4. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob Agents Chemother. 2006 Jul. 50(7):2409-14. . . CDC. Final 2008 West Nile Virus Activity in the United States
  5. Background. Enterovirus (EV) meningitis is common in infants and may have neurologic complications. Treatment of older children and adults with pleconaril has been associated with reduced severity and duration of symptoms. This study evaluated the pharmacokinetics, safety and efficacy of pleconaril in infants with EV meningitis. Methods
  6. Treatment of enterovirus meningitis with pleconaril (VP 63843) an antipiconaviral agent. Accepted for presentation at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Ontario, Canada, September 28-October 1, 1997. Google Schola

Desmond RA, Accortt NA, Talley L, et al. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob Agents Chemother 2006; 50:2409. Ruan F, Yang T, Ma H, et al. Risk factors for hand, foot, and mouth disease and herpangina and the preventive effect of hand-washing Enteroviral meningitis causes appreciable morbidity in adults, including hospitalization, decreased activity, and headache. Limited data define the natural history of disease. No antiviral therapeutic agent has demonstrated improved outcome in controlled clinical trials. Pleconaril, an inhibitor of enterovirus replication, was tested in two placebo-controlled clinical trials. Of 607 randomized.

The drug's name is pleconaril -- expect a catchy trade name soon -- and instead of singling out any one virus, it fights an entire family of disease-causing bugs. The drug tucks itself into a.. Pleconaril, an inhibitor of enterovirus replication, was tested in two placebo-controlled clinical trials. Of 607 randomized patients in a multicenter, double-blind placebo-controlled study of pleconaril (200 mg three times daily versus an identical-appearing placebo), 240 patients were confirmed to have enterovirus infection

PPT - MENINGITIS y Reacción en Cadena de la Polimerasa

Pleconaril, an antiviral agent initially developed to treat the common cold, shows activity against the enteroviruses that cause meningitis. Now, researchers (one of them employed by the company that developed pleconaril) have analyzed the data from two industry-sponsored, multicenter, placebo-controlled trials of pleconaril (200 mg 3 times.

Pleconaril - Stanford Universit

  1. Pediatric studies of pleconaril for enterovirus meningitis have had inconsistent results.[112,113] Results of pediatric studies of the treatment and prevention of upper respiratory tract infections are pending. An additional category for which pleconaril has been evaluated is severe enterovirus disease treated via a compassionate use mechanism
  2. In this patient group, chronic enteroviral meningitis (CEMA) is feared because of extensive morbidity and high fatality rate. Treatment options consist of intravenous immuno-globulin (IVIG), with various outcomes. Pleconaril is an anti-viral agent with in vitro activity against HEVs that has been used in the treatment of HEV infections
  3. 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 othe
  4. Pleconaril has demonstrated an excellent safety profile in dose escalation and clinical studies. Clinical studies have reported a reduction in the duration and intensity of symptoms in children and adults with enteroviral meningitis and in adults with rhinoviral respiratory tract infections treated with pleconaril

Newer treatments such as pleconaril 7,8 may provide benefit in the treatment of life-threatening enteroviral infections. 43 However, early identification of the causative agent is vital for potential effectiveness of these therapies. Repeated viral cultures of the oral mucosa, rectal mucosa, and CSF are recommended in all patients suspected of. Pleconaril. Pleconaril (Picovir) is an antiviral drug developed by Schering-Plough, now Merck. It has activity against Picornaviridae viruses including Enteroviruses and Rinoviruses. Pleconaril has shown promise for the treatment of enteroviruses in a number of in vitro and clinical studies

Enteroviral meningitis: natural history and outcome of

  1. istration (FDA)
  2. e if someone has meningitis.
  3. istration for this indication. • This agent is no longer under clinical development
  4. Aseptic meningitis is defined as a syndrome with acute onset of meningeal symptoms, fever and cerebrospinal fluid pleocytosis with bacteriologically sterile cultures and absence of parenchymal brain involvement. The only 2 agents that inhibit viral attachment or cell entry tested so far in vivo are pleconaril and lactoferrin, whereas newer.
  5. Desmond RA, Accortt NA, Talley L, et al. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob Agents Chemother . 2006;50(7):2409-14. [PMID:16801419

Oral Pleconaril Reduces the Duration and Severity of

Pleconaril in Infants with Enterovirus Meningitis 2003

Pleconaril is an antiviral drug potentially for the treatment of enterovirus infection and asthma. Pleconaril, administered either orally or intranasally, is active against viruses in the Picornaviridae family, including Enterovirus and Rhinovirus.It has shown useful activity against the dangerous strain enterovirus D68. Pleconaril binds to a hydrophobic pocket in the VP1 protein Meningitis: inflammation of the membranes of the brain or spinal cord AKA arachnoiditis or leptomeningitis CSF and meninges Encephalitis: inflammation of the brain itself Parenchyma Presence OR absence of normal brain function is the important distinguishing feature between encephalitis and meningitis April 11, 2000 (Atlanta) -- Two months ago, a lot of people were talking excitedly about the drug pleconaril. It showed promise in treating viral meningitis and even taming the common cold.It didn. Strong antiviral activity was detected against ECHO11 and EV68, which are known to cause outbreaks of aseptic meningitis and acute lower respiratory tract infections, respectively. 14 The highest activities were measured against high-level pleconaril-resistant viruses including RV5, RV42, RV44, RV48, and RV69. 4a, 4c, 10 The IC 50 values for. Viral meningitis is the most common form of meningitis. It's typically mild and goes away without treatment. Viral meningitis is a virus-borne inflammation of the meninges, which are the.

The finding of >5 white blood cells/mm3 of CSF is abnormal and is indicative of meningitis. The patient was treated for bacterial meningitis because of the predominance of neutrophils in the CSF. Early in the course of viral meningitis (the first 24 to 48 h), neutrophils can be predominant. Pleconaril binds reversibly to a hydrophobic. Rotbart HA, Webster AD, Pleconaril Treatment Registry Group. Treatment of potentially life-threatening enterovirus infections with pleconaril. Clin Infect Dis 2001;32:228--35. Collaborative Antiviral Study Group. Clinical trials. Pleconaril enteroviral sepsis syndrome. Protocol CASG 106 (DMID#99-018) Enteroviral meningitis: natural history and outcome of pleconaril therapy. AU Desmond RA, Accortt NA, Talley L, Villano SA, Soong SJ, Whitley RJ SO Antimicrob Agents Chemother. 2006;50(7):2409. Enteroviral meningitis causes appreciable morbidity in adults, including hospitalization, decreased activity, and headache capsid inhibitor, pleconaril, has been shown to have activity against viruses from thePicornaviridaefamily. Abzug et al performed a randomized controlled trial and reported a shorter time to PCR and culture negativity, as well as greater survival, in neonates with enteroviral sepsis who received pleconaril. (9) Other additional stud Those receiving pleconaril had a 2-day shorter duration of headache and a 2-day faster resolution of all symptoms of meningitis. Pleconaril-treated patients also returned to work or school 2 days faster. 74. Pleconaril is in phase 3 clinical trials for both meningitis and viral respiratory infections caused by the picornaviruses

Pleconaril - an overview ScienceDirect Topic

  1. Thus, if you have concerning symptoms and you think it is meningitis, go to your doctor and report your symptoms as soon as possible to prevent further damage to your central nervous system and severe complications that may become life-threatening. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrobial.
  2. Shafran SD, Halota W, Gilbert D, et al. Pleconaril is effective for enteroviral meningitis in adolescents and adults: a randomized placebo-controlled multicenter trial. In: Proceedings of the 39th Interscience Conference on Anitimicrobial Agents and Chemotherapy; Abstract 1904, presented September 26-29, 1999; San Francisco, CA
  3. In addition, treatment with pleconaril may have affected the severity of the encephalitis. This article reviews the pathogenesis, clinical manifestations, and differential diagnoses of enteroviral infections, specifically focusing on the prevention, treatment, and prognosis of the disease and the implications for clinical practice
  4. The antiviral drug, Pleconaril, has been used in clinical trials of aseptic meningitis, however it's not effective against EV71. Other capsid-function inhibitors have been studied, some of which have promising activities against EV71. Intravenous immunoglobulin has been used in the large outbreaks of EV71 in Asia
  5. Enteroviral Meningitis: Natural History and Outcome of Pleconaril Therap
  6. ViroPharma Inc.'s stock tumbled more than 38 percent Thursday after the pharmaceutical company disclosed mixed results from a study of its viral-meningitis drug pleconaril
  7. aseptic meningitis and acute lower respiratorytract infections, respectively.[14] The highest activities were measured against high-level pleconaril-resistant viruses including RV5, RV42, RV44, RV48, and RV69.[4a,c,10] The IC 50 values for these specific EVs ranged from 0.04 to 0.64 mm (Table S2 in the Supporting Information)

Other studies have shown that pleconaril can reduce the course of a viral meningitis infection by two to three days. The drug is still in Phase II studies, -- meant to show a compound is safe and. Meningitis has severe complications, including cerebral edema, septic arthritis, and pericardial effusion, and may also result in long-lasting consequences such as deafness, paralysis, intellectual problems, and much more. Thus, an early treatment is your way to go to prevent all of these consequences in yourself and your siblings With the advent of pleconaril, such infections may also be treatable. Further research is required to delineate the size of this problem and to determine the effectiveness of pleconaril in the neonatal population. In conclusion, neonatal enterovirus myocarditis may be an under recognised cause of neonatal collapse Edmond K et al. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10(5):317-28. Desmond RA et al. Enteroviral meningitis: natural history and outcome of pleconaril therapy. Antimicrob Agents Chemother. 2006;50(7):2409-14. Attia J, Hatala R Se describen 60 casos de meningitis por enterovirus; todos los casos se agruparon entre los meses de mayo y julio. La mediana de edad fue 6 años. La mitad de los casos consultaron en las primeras 6 h de enfermedad y el 20% en las primeras 2 h. Los síntomas predominantes fueron cefalea (97 %) y vómitos (80 %)

Meningitis: Distinguishing the benign from the serious Aseptic meningitis has a self-limited course, but bacterial meningitis can be lethal. An expeditious diagnostic approach helps to differentiate between the two. 2008. Michel Statler. Download PDF. Download Full PDF Package. This paper Further studies of pleconaril in other enteroviral diseases, including viral respiratory infection, will clarify the extent of the drug's efficacy. Read the full article. Get immediate access.

Soong and R. J. Whitley}, title = {Enteroviral meningitis: Natural history and outcome of pleconaril therapy}, journal = {Antimicrob. Agents Chemother. 2006}, year = {}, pages = {2409--2414}} Share. OpenURL . Abstract. These include: This article cites 11 articles, 4 of which can be accessed free at:. Pleconaril has potent anti-enteroviral activity and has been demonstrated to be efficacious for enteroviral meningitis. Pleconaril may have a role in the therapy of enteroviral myelitis. Postinfectious myelitis is treated with corticosteroid therapy to attenuate the inflammatory response. Infectious myelitis is a devastating illness S D Shafran (University of Alberta, Edmonton, Canada) reported a randomised placebocontrolled trial of pleconaril in patients aged 14-65 years with confirmed enteroviral meningitis. Compared with those treated with placebo, pleconaril-treated patients had a significant 2-day reduction in time to resolution of headache and symptoms of. Pleconaril is a small-molecule inhibitor with activity against viruses in the picornaviridae family, including enterovirus and rhinovirus. Pleconaril binds to a hydrophobic pocket in the major capsid protein and prevents uncoating of the viral RNA genome. In enteroviruses it also prevents the virus from attaching itself to the host cell

Enteroviruses Follow-up: Inpatient & Outpatient

Pleconaril is a novel compound that integrates into the capsid of picornaviruses, including enteroviruses and rhinoviruses, preventing the virus from attaching to cellular receptors and uncoating to release RNA into the cell. Pleconaril was used on a compassionate-release basis to treat patients with potentially life-threatenin However, pleconaril is still being investigated for use in the treatment of life-threatening complications of enteroviruses, such as meningitis and sepsis. It is also being investigated for use in the global eradication of a specific enterovirus, polio. 6 Pleconaril seems to work by binding to the viral capsid and preventing the uncoating of.

Treatment of Neonatal Enterovirus Infections Journal of

Aseptic Meningitis Johns Hopkins ABX Guid

How frequently does coxsackievirus infection cause aseptic

Treatment of viral meningitis • Generally supportive treatment is given. • Pleconaril has been evaluated for enteroviral meningitis with modest benefit. • Acyclovir (10 mg/kg IV every 8 hours) for HSV meningitis (controversial). • Intravenous immunoglobin has been used in agammaglobulinemic patients with chronic enteroviral meningitis meningitis and transferred to a tertiary maternity hospital. Cerebrospinal fl uid (CSF) polymerase chain reaction (PCR) was positive for enteroviral ribonucleic acid (RNA), confi rming viral meningitis. Ms X improved clinically and was discharged after six days. A high index of suspicion is required for diagnosis of meningitis in pregnancy

Viral Meningitis - Neurologic Disorders - Merck Manuals

Aseptic meningitis is a syndrome of meningeal inflammation in which common bacterial pathogens cannot be identified in the cerebrospinal fluid (CSF) -Pleconaril is an inhibitor of enteroviruses that is non-toxic, orally bioavailable and systemically actin The antiviral drug pleconaril has shown to be an effective treatment in some severe enteroviral infections. Pleconaril is not available in New Zealand (December 2016). What is the outcome of enteroviral infections? Most enteroviral infections heal spontaneously within 7-10 days. Cutaneous lesions heal without scarring

Viral Meningitis Meningitis Research Foundatio

The antiviral drug pleconaril has activity against many enteroviruses but is not available commercially. Pocapavir is another antiviral drug that is being developed primarily for the treatment of chronic poliovirus infection in patients with a primary immunodeficiency and has some activity in vitro against some nonpolio enteroviruses VIRION. Non-enveloped, spherical, about 30 nm in diameter, T=pseudo3 icosahedral capsid surrounding the naked RNA genome. The capsid consists of a densely-packed icosahedral arrangement of 60 protomers, each consisting of 4 polypeptides, VP1, VP2, VP3 and VP4. VP4 is located on the internal side of the capsid. Enterovirus

Treatment of Potentially Life-Threatening Enterovirus

The results of brain imaging (CT with contrast and MRI with gadolinium) were normal.1 A lumbar puncture was performed to look for aseptic meningitis and study cerebrospinal fluid (CSF) cell cytology and oligoclonal IgG.2 It revealed CSF under normal pressure, with normal protein and glucose levels and 0.11 х 10 9 /L leukocytes (97% mononuclear cells) of normal morphology on cytological. Shafran S, Halota W, Gilbert D, Bernstein J, Reiss M, The 29. Modlin JF (1988) Perinatal echovirus and group B coxsackie- Collaborative Meningitis Group (1999) Pleconaril is effective virus infections. Clin Perinatol 15: 233-246 for enteroviral meningitis in adolescents and adults:a random- 30 Pleconaril, an experimental agent with in vitro activity against most enteroviruses, was evaluated in clinical trials, in a study of 79 patients, those treated with the agent demonstrated modest benefit. But Pleconaril has not been approved by the FDA for use as an antiviral agent 18). Echovirus infection prognosi

Neonatal Meningitis Medication: Antivirals, Other

Treatment of potentially life-threatening enterovirus infections with pleconaril Treatment of potentially life-threatening enterovirus infections with pleconaril Tunkel, Allan 2001-05-18 00:00:00 348 Central Nervous System and Eye Infections world. In addition, there is significant morbidity in mycin, an antimicrobial agent that may be required to treat patients who survive their episode of. In 1991, a new antiviral pleconaril which is a novel orally bioavailable and systematically acting small molecule inhibitor for picornaviruses. Pleconaril is currently in clinical trials for treatment of enterovirus meningitis and respiratory infections. **** Oral pleconaril was ViroPharma's first compound, licensed from Sanofi in 1997. Pleconaril is active against viruses in the picornavirus family. ViroPharma's first indication was for enteroviral meningitis, but that indication was abandoned when the clinical trials did not demonstrate efficacy.. In 2001, ViroPharma submitted an New Drug Application of pleconaril to the FDA for the common cold Pediatric aseptic meningitis is an inflammation of the meninges caused mainly by nonbacterial organisms, specific agents, or other disease processes. Aseptic meningitis (including viral meningitis) is the most common infection of the central nervous system (CNS) in the pediatric population, occurring most frequently in children younger than 1 year Objective To assess the severity of the disease and the long-term cardiac prognosis for neonates who developed enterovirus (EV) myocarditis within the first weeks of life. Design Clinical presentation, echocardiographic and ECG findings and the outcome of seven infants with EV myocarditis admitted to the intensive care unit are reported. Additionally, 28 previously reported cases are described.

What does a finding of pleocytosis indicate in the workup

Viral meningitis Enterovirus (EV) caused meningitis. This is the most common cause of viral meningitis, with 90% of viral In fact, 90 percent of all meningitis cases that are viral are caused by enteroviruses. Other viruses that may cause aseptic The most common cause of aseptic meningitis is a viral infection, specifically by.

Presentation, Diagnosis, and Management of EnterovirusPPT - Natural History of Picornavirus Colds in AdultsCoxsackieviruses an updatePicornavirus