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Dear Dr. K – I heard that there is a new drug to treat flu. Is that true? And, does it work?

Dear Dr. K – I heard that there is a new drug to treat flu. Is that true? And, does it work?

Yes, and yes.  The new drug is Xofluza and it is the first flu drug with a new mechanism of action to come along in 20 years.  It is (hold on to your hat) a polymerase acidic endonuclease inhibitor, (PAEI).  PAEI is essential for the viral RNA messenger that allows the flu virus to replicate itself.  By shutting down viral replication, it shuts down the infection.  It is effective for both influenza A and B.

 

The only other available drugs for influenza all work by the same, but different than Xofluza, mechanism which is to inhibit neuraminidase.  These drugs are:  Tamiflu, Relenza and Rapivab.  Neuraminidase is an enzyme of the virus that allows it to escape from one human cell so it can invade the next cell.  By inhibiting neuraminidase these drugs also shut down the infection.  Tamiflu is oral, Relenza is a nasal spray and Rapivab is IV (used in hospitalized, severely ill patients).

 

The new drug works as well, but not better than the other three.  However, one dose is sufficient.  It works best if started within 48 hours of becoming ill.  Being new it is naturally more expensive.  Unfortunately, influenza seems to be able to develop resistance to the new drug fairly quickly.  Ten percent of patients developed resistance after a single dose.

 

Resistance is also a problem with the neuraminidase inhibitors, so the FDA is studying the possibility of combining both families of drugs for their synergism (killing virus by different mechanisms) and as a means to prevent resistance.

Q – Tips: flu and Q Fever

Q – Tips: flu and Q Fever

  • Q-Fever is a flu mimic that causes prolonged flu- like symptoms and pneumonia. It is caused by a small bacterium Coxiella Burnetii, which is re- leased from infected female mammals, especially when they give birth: cattle, sheep, cats, dogs and rabbits. There was a recent series of cases at a Florida school, where a classroom rabbit had bunnies, exposing the children.
Statin drugs come with bonus positive prevention attributes

Statin drugs come with bonus positive prevention attributes

The recent Journal of Allergy and Clinical Immunology had an article about statins and asthma. The attention was not just for these drugs’ cholesterol-lowering properties, but also their immune-modulatory and anti-inflammation effects.

You might remember that several years ago there was concern for a possibly highly lethal global flu pandemic. The Center for Disease Control and Prevention recommended stockpiling not only anti-flu medication, but also statins. This is because they can prevent death from an otherwise lethal flu infection thanks to these bonus effects they include.

Well, apparently these same benefits are leading to better asthma outcomes.

A longtime study comparing two asthma groups, one of which was on statins, showed reduction in both rescue inhaler and steroid-burst use and fewer ER visits for the group on statins.

Also of interest are new guidelines for statin use. These new recommendations are to use lower doses, as it seems a large part of the benefit of statins in heart disease is owing to their reducing blood vessel inflammation, not just cholesterol levels. This anti-inflammation effect occurs with lower doses, which are less likely to lead to side effects.

Dear Doc: One-time flu shot in the pipeline?

Dear Doc: One-time flu shot in the pipeline?

Dear Dr. K: I heard there is work being done on a one-time flu shot. Is this true?

Yes, Virginia, there is a Santa Claus and with any luck, there may also be a one-time flu vaccine. Before I discuss this new research let me review the current vaccine.

Traditional influenza vaccines target the globular outer region of the viral hemaggluttinin protein. This part of the protein is constantly changing and accounts for the new strains of flu seen each year. Moreover, for each year’s vaccine to work, scientists must accurately predict these new strains so that the vaccine is effective.

The new vaccine research is targeting the stem of the hemaggluttinin protein, which rarely changes. This stem protein is found across the board in all influenza strains. Thus, eliciting antibody production to this common protein will create broadly neutralizing immunity to all flu viruses. Therefore, one vaccine will prevent all types of flu.

Researchers have already tested this vaccine in mice and it protected them from a lethal dose of flu. If further tests in animals have success, human studies will soon follow.