Is it a cure? The makers of pleconaril (pronounced plah-CONN-ah-rill), say it's as close as it gets. "There are over 400 to 500 million cases of diseases caused by viruses in this country alone and the opportunity is quite great for this drug," says Vincent Milano, who works for the drug's developers at ViroPharma Inc.
"Everyone talks about the cure for the common cold," says Dr. Jose Romero of Creighton University in Nebraska, who has tested the drug on patients. "This IS the cure for the common cold."
The latest in a short list of medicines that kill viruses, this drug blocks an entire category of them, a collection of 169 distinctly different nasties that together cause more human disease than any other.
According to CBS Medical Consultant Dr. Bernadine Healy, President of the American Red Cross, "This drug can help with major life threatening illnesses cause by a family of viruses. We're talking about encephalitis, a deep brain infection, we talking about myarcarditis, even polio."
Almost as remarkable as what pleconaril does, however, is how it came to be. This drug was not so much discovered as designed.
Once drug development was a kind of organized serendipity, screening thousands of random compounds to see what happens. But over the past decade, a quiet series of breakthroughs has transformed the way drugs are developed. Now scientists explore the shape and innards of their target right down to the last molecule. Then they fashion chemical monkey wrenches to throw into the works.
Pleconaril is the newest, and one of the most impressive, examples of this new way of creating medicines. It is an exquisitely precise sort of monkey wrench. The drug fits neatly into a groove on the surface of the virus, gumming up the machinery it needs to infect the body's cells.
The mass-appeal of pleconaril will be widespread if clinical trials confirm that a pill form does drastically cut the duration and intensity of the common cold.
ViroPharma plans to charge between $50 and $100 for enough medicine to cure one infection, making the profit from the millions of colds suffered each year nothing to sneeze at.
Dr Healy cautions, however, that it's way too soon to call this a wonder drug. "Let's not jump the gun," she says. "The FDA hasn't had a chance to bring in its panel of experts to review this data. We're not seeing and hearing the whole body of evidence being reviewed by experts."
ViroPharma hopes first to prove that pleconaril cures viral meningitis, an inflammation of the covering of the brain and spine. The CDC estimates that about 50,000 Americans are hospitalized with it each year, and besides painkillers, there is little doctors can now offer.
So far, small studies on victims of viral meningitis hae looked promising, and the results of two large meningitis studies are expected in the spring.
If they turn out as ViroPharma hopes, research director Mark A. McKinlay says the company will immediately seek approval to sell the drug. With a speedy FDA review, this could put a liquid form of pleconaril on the market by the end of 2000.
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