Simnotrelvir/ritonavir

Simnotrelvir
Clinical data
Other names	SIM0417, SSD8432
Routes of; administration	Oral
Drug class	SARS-CoV-2 3CLpro inhibitor
Legal status
Legal status	Not approved on its own;
Pharmacokinetic data
Protein binding	72.5%
Metabolism	hepatic (CYP3A)
Elimination half-life	3.1 h; 4.1 h with ritonavir
Excretion	urine (55.4%), feces (36.7%)
Identifiers
	IUPAC name (8S)-N-[(1S)-1-cyano-2-[(3S)-2-oxopyrrolidin-3-yl]ethyl]-7-[(2S)-3,3-dimethyl-2-[(2,2,2-trifluoroacetyl)amino]butanoyl]-1,4-dithia-7-azaspiro[4.4]nonane-8-carboxamide;
PubChem CID	168476146;
Chemical and physical data
Formula	C22H30F3N5O4S2
Molar mass	549.63 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES CC(C)(C)[C@@H](C(=O)N1CC2(C[C@H]1C(=O)N[C@@H](C[C@@H]3CCNC3=O)C#N)SCCS2)NC(=O)C(F)(F)F;
	InChI InChI=InChI=1S/C22H30F3N5O4S2/c1-20(2,3)15(29-19(34)22(23,24)25)18(33)30-11-21(35-6-7-36-21)9-14(30)17(32)28-13(10-26)8-12-4-5-27-16(12)31/h12-15H,4-9,11H2,1-3H3,(H,27,31)(H,28,32)(H,29,34)/t12-,13-,14-,15+/m0/s1; Key:LQBRGTAIBBFUJJ-ZQDZILKHSA-N;

Simnotrelvir/ritonavir
	Chemical structures of simnotrelvir (top) and ritonavir (bottom)
Combination of
Simnotrelvir	SARS-CoV-2 3CLpro inhibitor
Ritonavir	Protease inhibitor
Clinical data
Trade names	先诺欣 (Xiannuoxin)
Pregnancy; category	Contraindicated (CN);
Routes of; administration	Oral
Legal status
Legal status	Rx in China;

Simnotrelvir/ritonavir (trade name Xiannuoxin) is a pharmaceutical drug used for the treatment of COVID-19.^[2] Simnotrelvir/ritonavir is a combination drug of simnotrelvir, an inhibitor of SARS-CoV-2 3CL^pro, and ritonavir,^[3] a CYP3A inhibitor.

It was developed by Simcere Pharmaceutical and conditionally approved in China by the National Medical Products Administration (NMPA) in January 2023.^[4] Results for the phase Ib trial are available.^[5] In a phase II/III trial, it reduced the duration of symptoms by a median of 36 hours compared to placebo.^[6]

References[edit]

^ ^a ^b ^c ^d Simcere (January 28, 2023). "先诺欣 [先诺特韦片/利托那韦片组合包装 Simnotrelvir Tablets/Ritonavir Tablets（co-packaged）]". Dxy.cn package insert database (in Chinese (China)). Retrieved 2 October 2023.
^ Zhu KW (September 2023). "Deuremidevir and Simnotrelvir-Ritonavir for the Treatment of COVID-19". ACS Pharmacology & Translational Science. 6 (9): 1306–1309. doi:10.1021/acsptsci.3c00134. PMC 10496140. PMID 37705591.
^ Wang Q, Chen G, He J, Li J, Xiong M, Su H, et al. (May 2023). "Structure-Based Design of Potent Peptidomimetic Inhibitors Covalently Targeting SARS-CoV-2 Papain-like Protease". International Journal of Molecular Sciences. 24 (10): 8633. doi:10.3390/ijms24108633. PMC 10218254. PMID 37239980.
^ "China approves two oral drugs to treat COVID-19". bioworld.com. January 30, 2023.
^ Wang F, Xiao W, Tang Y, Cao M, Shu D, Asakawa T, et al. (September 2023). "Efficacy and safety of SIM0417 (SSD8432) plus ritonavir for COVID-19 treatment: a randomised, double-blind, placebo-controlled, phase 1b trial". The Lancet Regional Health. Western Pacific. 38: 100835. doi:10.1016/j.lanwpc.2023.100835. PMC 10362366. PMID 37484496.
^ Cao B, Wang Y, Lu H, Huang C, Yang Y, Shang L, et al. (2024-01-18). "Oral Simnotrelvir for Adult Patients with Mild-to-Moderate Covid-19". New England Journal of Medicine. 390 (3): 230–241. doi:10.1056/NEJMoa2301425. PMID 38231624. S2CID 267030019.

External links[edit]

NHSA slideshow, also shows adverse effect data from phase II/III

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[insert-1] Simcere (January 28, 2023). "先诺欣 [先诺特韦片/利托那韦片组合包装 Simnotrelvir Tablets/Ritonavir Tablets（co-packaged）]". Dxy.cn package insert database (in Chinese (China)). Retrieved 2 October 2023.

[2] Zhu KW (September 2023). "Deuremidevir and Simnotrelvir-Ritonavir for the Treatment of COVID-19". ACS Pharmacology & Translational Science. 6 (9): 1306–1309. doi:10.1021/acsptsci.3c00134. PMC 10496140. PMID 37705591.

[3] Wang Q, Chen G, He J, Li J, Xiong M, Su H, et al. (May 2023). "Structure-Based Design of Potent Peptidomimetic Inhibitors Covalently Targeting SARS-CoV-2 Papain-like Protease". International Journal of Molecular Sciences. 24 (10): 8633. doi:10.3390/ijms24108633. PMC 10218254. PMID 37239980.

[4] "China approves two oral drugs to treat COVID-19". bioworld.com. January 30, 2023.

[5] Wang F, Xiao W, Tang Y, Cao M, Shu D, Asakawa T, et al. (September 2023). "Efficacy and safety of SIM0417 (SSD8432) plus ritonavir for COVID-19 treatment: a randomised, double-blind, placebo-controlled, phase 1b trial". The Lancet Regional Health. Western Pacific. 38: 100835. doi:10.1016/j.lanwpc.2023.100835. PMC 10362366. PMID 37484496.

[NEJM2024-6] Cao B, Wang Y, Lu H, Huang C, Yang Y, Shang L, et al. (2024-01-18). "Oral Simnotrelvir for Adult Patients with Mild-to-Moderate Covid-19". New England Journal of Medicine. 390 (3): 230–241. doi:10.1056/NEJMoa2301425. PMID 38231624. S2CID 267030019.

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External links[edit]