Small-molecule anti-COVID-19 drugs and a focus on China's homegrown mindeudesivir (VV116)

Front Med. 2023 Dec;17(6):1068-1079. doi: 10.1007/s11684-023-1037-3. Epub 2024 Jan 2.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has stimulated tremendous efforts to develop therapeutic agents that target severe acute respiratory syndrome coronavirus 2 to control viral infection. So far, a few small-molecule antiviral drugs, including nirmatrelvir-ritonavir (Paxlovid), remdesivir, and molnupiravir have been marketed for the treatment of COVID-19. Nirmatrelvir-ritonavir has been recommended by the World Health Organization as an early treatment for outpatients with mild-to-moderate COVID-19. However, the existing treatment options have limitations, and effective treatment strategies that are cost-effective and convenient for tackling COVID-19 are still needed. To date, four domestically developed oral anti-COVID-19 drugs have been granted conditional market approval in China. These drugs include azvudine, simnotrelvir-ritonavir (Xiannuoxin), leritrelvir, and mindeudesivir (VV116). Preclinical and clinical studies have explored the efficacy and tolerability of mindeudesivir and supported its early use in mild-to-moderate COVID-19 cases at high risk for progression. In this review, we discuss the most recent findings regarding the pharmacological mechanism and therapeutic effects focusing on mindeudesivir and other small-molecule antiviral agents for COVID-19. These findings will expand our understanding and highlight the potential widespread application of China's homegrown anti-COVID-19 drugs.

Keywords: COVID-19; antiviral drugs; mindeudesivir.

Publication types

  • Review

MeSH terms

  • Adenosine* / analogs & derivatives
  • Antiviral Agents / therapeutic use
  • COVID-19*
  • China
  • Humans
  • Lactams*
  • Leucine*
  • Nitriles*
  • Proline*
  • Ritonavir* / therapeutic use

Substances

  • GS-621763
  • nirmatrelvir
  • Ritonavir
  • Antiviral Agents
  • Nitriles
  • Lactams
  • Proline
  • Adenosine
  • Leucine