Antiviral efficacy upon administration of a HepDirect prodrug of 2'-C-methylcytidine to hepatitis C virus-infected chimpanzees

Antimicrob Agents Chemother. 2011 Aug;55(8):3854-60. doi: 10.1128/AAC.01152-10. Epub 2011 May 31.

Abstract

Hepatitis C virus (HCV) infects an estimated 170 million individuals worldwide, and the current standard of care, a combination of pegylated interferon alpha and ribavirin, is efficacious in achieving sustained viral response in ~50% of treated patients. Novel therapies under investigation include the use of nucleoside analog inhibitors of the viral RNA-dependent RNA polymerase. NM283, a 3'-valyl ester prodrug of 2'-C-methylcytidine, has demonstrated antiviral efficacy in HCV-infected patients (N. Afdhal et al., J. Hepatol. 46[Suppl. 1]:S5, 2007; N. Afdhal et al., J. Hepatol. 44[Suppl. 2]:S19, 2006). One approach to increase the antiviral efficacy of 2'-C-methylcytidine is to increase the concentration of the active inhibitory species, the 5'-triphosphate, in infected hepatocytes. HepDirect prodrug technology can increase intracellular concentrations of a nucleoside triphosphate in hepatocytes by introducing the nucleoside monophosphate into the cell, bypassing the initial kinase step that is often rate limiting. Screening for 2'-C-methylcytidine triphosphate levels in rat liver after oral dosing identified 1-[3,5-difluorophenyl]-1,3-propandiol as an efficient prodrug modification. To determine antiviral efficacy in vivo, the prodrug was administered separately via oral and intravenous dosing to two HCV-infected chimpanzees. Circulating viral loads declined by ~1.4 log(10) IU/ml and by >3.6 log(10) IU/ml after oral and intravenous dosing, respectively. The viral loads rebounded after the end of dosing to predose levels. The results indicate that a robust antiviral response can be achieved upon administration of the prodrug.

MeSH terms

  • Animals
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Cytidine / administration & dosage
  • Cytidine / analogs & derivatives*
  • Cytidine / pharmacology
  • Cytidine / therapeutic use
  • Cytidine Monophosphate / administration & dosage
  • Cytidine Monophosphate / analogs & derivatives
  • Cytidine Monophosphate / pharmacology
  • Cytidine Monophosphate / therapeutic use
  • Female
  • Hepacivirus / drug effects*
  • Hepatitis C / drug therapy*
  • Hepatitis C / virology
  • Hepatocytes / metabolism
  • Macaca mulatta
  • Male
  • Pan troglodytes
  • Prodrugs / administration & dosage*
  • Prodrugs / pharmacology
  • Prodrugs / therapeutic use
  • Pyrimidine Nucleosides / administration & dosage
  • Pyrimidine Nucleosides / pharmacology
  • Pyrimidine Nucleosides / therapeutic use
  • Rats
  • Rats, Sprague-Dawley
  • Viral Load / drug effects

Substances

  • Antiviral Agents
  • Prodrugs
  • Pyrimidine Nucleosides
  • 2'-C-methylcytidine
  • Cytidine
  • Cytidine Monophosphate
  • valopicitabine