Editing Rhinovirus (section)

== Novel antiviral drugs ==
There are currently no FDA-approved [[antiviral drugs]] to treat rhinovirus infections.<ref name="www.cdc.gov_2023" /> Several novel antiviral compounds have been tested in clinical trials without sufficient efficacy to progress to FDA approval. Compounds specifically targeted for rhinoviruses, or more broadly, picornaviruses, include the following:

* [[Rupintrivir]] is a [[peptidomimetic]] drug developed for treatment of rhinovirus infections.<ref>{{cite journal | vauthors = Patick AK, Binford SL, Brothers MA, Jackson RL, Ford CE, Diem MD, Maldonado F, Dragovich PS, Zhou R, Prins TJ, Fuhrman SA, Meador JW, Zalman LS, Matthews DA, Worland ST | title = In vitro antiviral activity of AG7088, a potent inhibitor of human rhinovirus 3C protease | journal = Antimicrobial Agents and Chemotherapy | volume = 43 | issue = 10 | pages = 2444–2450 | date = October 1999 | pmid = 10508022 | pmc = 89498 | doi = 10.1128/AAC.43.10.2444 }}</ref> Rupintrivir inhibits human rhinovirus [[Picornain 3C|3Cprotease]] and prevents cleavage of the rhinovirus [[Proteolysis|polyprotein]] following translation, therefore preventing viral assembly and replication. A phase II clinical trial of rupintrivir using [[Human challenge study|experimentally induced rhinovirus infection]] in healthy volunteers demonstrated efficacy in reducing viral load and symptom severity. However, further trials testing rupintrivir in treating natural infections showed minimal benefit, and further clinical development was halted.<ref name="Coultas_2021">{{cite journal | vauthors = Coultas JA, Cafferkey J, Mallia P, Johnston SL | title = Experimental Antiviral Therapeutic Studies for Human Rhinovirus Infections | journal = Journal of Experimental Pharmacology | volume = 13 | pages = 645–659 | date = July 2021 | pmid = 34276229 | pmc = 8277446 | doi = 10.2147/JEP.S255211 | doi-access = free }}</ref>
* [[Pleconaril]] is an orally [[bioavailable]] antiviral drug developed for the treatment of infections caused by [[picornaviruses]].<ref name="Pevear_1999">{{cite journal | vauthors = Pevear DC, Tull TM, Seipel ME, Groarke JM | title = Activity of pleconaril against enteroviruses | journal = Antimicrobial Agents and Chemotherapy | volume = 43 | issue = 9 | pages = 2109–2115 | date = September 1999 | pmid = 10471549 | pmc = 89431 | doi = 10.1128/AAC.43.9.2109 }}</ref> This drug acts by binding to a hydrophobic pocket in VP1, and stabilizes the protein capsid to such an extent that the virus cannot release its RNA genome into the target cell. Phase III clinical trials showed a slight reduction in symptom duration if taken within 24 hours of symptom onset.<ref>{{cite journal | vauthors = Pevear DC, Hayden FG, Demenczuk TM, Barone LR, McKinlay MA, Collett MS | title = Relationship of pleconaril susceptibility and clinical outcomes in treatment of common colds caused by rhinoviruses | journal = Antimicrobial Agents and Chemotherapy | volume = 49 | issue = 11 | pages = 4492–4499 | date = November 2005 | pmid = 16251287 | pmc = 1280128 | doi = 10.1128/AAC.49.11.4492-4499.2005 }}</ref><ref name="Fleisher_2003">{{cite journal | vauthors = Fleischer R, Laessig K | title = Safety and efficacy evaluation of pleconaril for treatment of the common cold | journal = Clinical Infectious Diseases | volume = 37 | issue = 12 | pages = 1722 | date = December 2003 | pmid = 14689362 | doi = 10.1086/379830 | doi-access = free }}</ref> However, the FDA denied approval of pleconaril due to concerns about side effects, limited efficacy in non-white participants, and difficulty in treating most patients within a 24 hour window.<ref>{{cite journal | vauthors = Senior K | title = FDA panel rejects common cold treatment | journal = The Lancet. Infectious Diseases | volume = 2 | issue = 5 | pages = 264 | date = May 2002 | pmid = 12062983 | doi = 10.1016/s1473-3099(02)00277-3 }}</ref><ref>{{cite journal | vauthors = Moynihan R, Bero L, Ross-Degnan D, Henry D, Lee K, Watkins J, Mah C, Soumerai SB | title = Coverage by the news media of the benefits and risks of medications | journal = The New England Journal of Medicine | volume = 342 | issue = 22 | pages = 1645–1650 | date = June 2000 | pmc = 1126289 | doi = 10.1136/bmj.326.7403.1403 | pmid = 10833211 }}</ref>

Other treatments aiming to reduce rhinovirus infection symptoms include immunomodulatory agents. These may promote beneficial antiviral responses or reduce inflammatory responses associated with symptoms. [[Interferon type I|Interferon-alpha]] used intranasally was shown to be effective against human rhinovirus infections. However, volunteers treated with this drug experienced some side effects, such as nasal bleeding and began developing [[Drug tolerance|tolerance]] to the drug. Subsequently, research into the treatment was abandoned.<ref name="Farr">{{cite journal | vauthors = Farr BM, Gwaltney JM, Adams KF, Hayden FG | title = Intranasal interferon-alpha 2 for prevention of natural rhinovirus colds | journal = Antimicrobial Agents and Chemotherapy | volume = 26 | issue = 1 | pages = 31–34 | date = July 1984 | pmid = 6089652 | pmc = 179911 | doi = 10.1128/aac.26.1.31 }}</ref> Inhaled [[budesonide]] has been shown to reduce viral load and pro-inflammatory [[Interleukin 1 beta|IL-1β]] in mice. [[Omalizumab]], which was developed for treatment of severe allergic asthma, has shown evidence in reducing symptom severity of asthma patients infected with rhinovirus.<ref name="Coultas_2021" />