Severe mammarenaviral disease in guinea pigs effectively treated by an orally bioavailable fusion inhibitor, alone or in combination with favipiravir

Antiviral Res. 2022 Dec:208:105444. doi: 10.1016/j.antiviral.2022.105444. Epub 2022 Oct 13.

Abstract

Infections by pathogenic New World mammarenaviruses (NWM)s, including Junín virus (JUNV), can result in a severe life-threatening viral hemorrhagic fever syndrome. In the absence of FDA-licensed vaccines or antivirals, these viruses are considered high priority pathogens. The mammarenavirus envelope glycoprotein complex (GPC) mediates pH-dependent fusion between viral and cellular membranes, which is essential to viral entry and may be vulnerable to small-molecule inhibitors that disrupt this process. ARN-75039 is a potent fusion inhibitor of a broad spectrum of pseudotyped and native mammarenaviruses in cell culture and Tacaribe virus infection in mice. In the present study, we evaluated ARN-75039 against pathogenic JUNV in the rigorous guinea pig infection model. The compound was well-tolerated and had favorable pharmacokinetics supporting once-per-day oral dosing in guinea pigs. Importantly, significant protection against JUNV challenge was observed even when ARN-75039 was withheld until 6 days after the viral challenge when clinical signs of disease are starting to develop. We also show that ARN-75039 combination treatment with favipiravir, a viral polymerase inhibitor, results in synergistic activity in vitro and improves survival outcomes in JUNV-challenged guinea pigs. Our findings support the continued development of ARN-75039 as an attractive therapeutic candidate for treating mammarenaviral hemorrhagic fevers, including those associated with NWM infection.

Keywords: ARN-75039; Antiviral; Arenavirus; Favipiravir; Junin virus; Mammarenavirus.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Amides / pharmacology
  • Amides / therapeutic use
  • Animals
  • Anti-Retroviral Agents / pharmacology
  • Arenaviridae*
  • Guinea Pigs
  • Hemorrhagic Fever, American* / drug therapy
  • Hemorrhagic Fevers, Viral*
  • Junin virus*
  • Mice
  • Pyrazines / pharmacology
  • Pyrazines / therapeutic use

Substances

  • favipiravir
  • Pyrazines
  • Amides
  • Anti-Retroviral Agents