Picornaviruses are important human pathogens causing severe morbidity and some mortality with the potential to cause worldwide crippling disease. Currently, there are few treatments for many of the viruses in the Picornaviridae, For rhinoviruses, there are no approved treatments, although
ruprintrivir looks promising in clinical trials and pyridazinyl
oxime ethers may prove useful. Poliovirus treatments are needed to supplement the World Health Organization's
polio eradication plan in order to treat
infections caused by reversion of the
attenuated vaccine virus and to supplement
vaccine coverage control in
polio endemic areas. However, no promising compounds for treatment of poliovirus have been developed due to the efficacy of the
vaccines in use. Broad-spectrum inhibitors developed for other picornavirus may be useful for poliovirus
infections.
Coxsackievirus infections in children and in infants are being treated with
pleconaril with some efficacy in reducing mortality and improving recovery, albeit the treatment is often on a compassionate use basis. There are no
therapies for
echovirus infections. Very little
drug discovery research is being done to develop inhibitors for
echovirus infections, probably due to the broad-spectrum inhibition exhibited by capsid binding agents and
protease inhibitors discovered for treatment of other picornaviruses. For example, pyridazinyl
oxime ethers are inhibitory to most echoviruses. Treatments for
enterovirus infections are also limited, although in a small clinical trial,
milrinone seemed to reduce mortality and improve recovery from EV71-induced
pulmonary edema. Thus, these results strongly emphasize the need for the development of potent and nontoxic compounds for the treatment of
picornavirus infections.