CUR-N399 is Curovir’s novel host-targeting enterovirus and respiratory syncytial virus antiviral. The drug is primarily being developed for use in respiratory infections, to prevent or ameliorate exacerbations of COPD (and asthma) as well as in preparedness for an EV pandemic.

The number of potential diseases for which a broad spectrum of anti-EV and RSV drugs can further be used is significant, and briefly discussed below. Curovir is also developing pleconaril (previously developed by Viropharma, Inc.) for treatment of type 1 diabetes.

Main populations in need of EV and RSV treatments

Both EV and RSV infections are known to primarily affect vulnerable populations. These groups include newborns, young children, the elderly, immunosuppressed patients, and those with certain coexisting diseases such as chronic respiratory diseases. The specifics of the vulnerability of these at-risk groups are summarized below:

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Main indications

There are several indications for which EV antivirals could be used. For CUR-N399, the indication that has been prioritized is exacerbations in COPD. Further, pleconaril is being evaluated for use in type 1 diabetes.

Chronic obstructive pulmonary disease (COPD)

In 2017, it was estimated that 544.9 million people were living with, and 3.9 million died from chronic respiratory diseases, making it the third leading causes of death globally.

Due to chronic changes in the lungs, respiratory infections are particularly troublesome for people with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma.

COPD is a seriously debilitating and eventually deadly disease, characterized by chronic bronchitis and emphysema. Symptoms include shortness of breath, wheezing, chest tightness, cough, increased mucus in the lungs and frequent respiratory infections. People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual, and last for at least several days. During exacerbations, hospitalization may be needed and there is an increased risk of serious complications and even death if not managed properly.

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Serious infections

Both EV and RSV cause serious infections in some subjects, mainly in immunosuppressed patient groups. Serious infection may present as severe respiratory infections, myocarditis, sepsis, hepatitis, meningitis myelitis and encephalitis.

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Pandemic preparedness

Most of the latest pandemics have been caused by viruses, and most of these have been variants of the influenza virus, which, like EV and RSV, is an RNA virus. Other recent examples of pandemic RNA viruses are COVID-19 (a coronavirus) and Zika virus (a flavivirus).

RNA viruses have also been identified as the class of pathogens that is most likely to cause a global catastrophic biological event: a situation that has the capacity to cause such significant damage to human civilization that it undermines the long-term potential of our species.

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Type 1 diabetes

Diabetes is a group of disorders characterized by high blood glucose levels. Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, is a chronic disease that usually debuts in childhood or adolescence.

It is characterized by the presence of autoantibodies against the beta cells that are involved in the production of insulin. Type 1 diabetes is a relatively rare disease, globally, affecting roughly 50 million people. The incidence of type 1 diabetes varies greatly between countries; the highest incidence (36.5/100,000) has been reported in Finland. The etiology of the disease is not known, but it is generally accepted that different factors, both genetic and environmental, contribute to the disease.

Viruses, especially EVs, are an environmental factor that is often identified as a possible causative factor in the development and or progression of type 1 diabetes.

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