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

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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.

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Acknowledgements

This work was supported by the National Major Scientific and Technological Special Project for “Significant New Drugs Development”(No. 2017ZX09304007), the National Natural Science Foundation of China (Nos. 82088102 and 81970728), the Science and Technology Commission of Shanghai Municipality (Nos. 22Y31900300 and 23XD1432600), and the Innovative Research Team of High-Level Local Universities in Shanghai. Yu Xu is supported by the “National Top Young Talents” program.

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  1. These authors contributed equally to this article.

Authors and Affiliations

  1. Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Qiuyu Cao, Yi Ding, Yu Xu, Mian Li, Ruizhi Zheng, Weiqing Wang, Yufang Bi & Guang Ning

  2. Shanghai National Clinical Research Center for Metabolic Diseases, State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Qiuyu Cao, Yi Ding, Yu Xu, Mian Li, Ruizhi Zheng, Weiqing Wang, Yufang Bi & Guang Ning

  3. Department of Infectious Disease, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Zhujun Cao

  4. Clinical Trials Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Yiping Xu

  5. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China

    Ren Zhao

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Correspondence to Yiping Xu or Ren Zhao.

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Conflicts of interest Qiuyu Cao, Yi Ding, Yu Xu, Mian Li, Ruizhi Zheng, Zhujun Cao, Weiqing Wang, Yufang Bi, Guang Ning, Yiping Xu, and Ren Zhao declare that they have no conflicts of interest.

This manuscript is a review article and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

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Cao, Q., Ding, Y., Xu, Y. et al. Small-molecule anti-COVID-19 drugs and a focus on China’s homegrown mindeudesivir (VV116). Front. Med. 17, 1068–1079 (2023). https://doi.org/10.1007/s11684-023-1037-3

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  • DOI: https://doi.org/10.1007/s11684-023-1037-3

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