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I wonder how much brincidofovir will cost though. Will it be priced beyond the reach of many ME/CFS patients?
Also, will brincidofovir work as well as Valcyte for treating ME/CFS?
If Valcyte's anti-inflammatory effects (it's a potent microglial inhibitor) and its immunomodulatory effects are part of why Valcyte helps ME/CFS, and if brincidofovir does not possess these mechanism of action, then brincidofovir may not replace Valcyte.
I have no idea what the cost will be. I know that Chimerix has a 30 year patent on the drug. So in terms of pricing, Chimerix is totally in control. Hopefully they won't be too greedy.
As for mechanism of action, they are quite similar in that they both preferentially inhibit viral DNA polymerases.
Here are some bits of info in regards to mechanism of action:
Cidofovir is a nucleotide analogue which inhibits viral DNA polymerase and is effective against human cytomegalovirus (CMV) infection. It is phosphorylated to its active form by cellular enzymes. With the long intracellular half-life of its metabolites, cidofovir can be administered weekly during induction and every other week during maintenance therapy.
Acting as an antiviral agent by preventing the replication of CMV, cidofovir targets viral DNA polymerase and prevents transcription. Because the viral polymerase is 8 to 600 times more sensitive than human DNA alpha, beta, and gamma polymerases, the active ingredient, cidofovir diphosphate, is able to specifically target viral replication processes.
Cidofovir is a monophosphate nucleotide analogue. After undergoing cellular phosphorylation to its diphosphate form, it competitively inhibits the incorporation of deoxycytidine triphosphate into viral DNA by viral DNA polymerase. Incorporation of the drug disrupts further chain elongation [1]. Unlike nucleoside analogues such as acyclovir or ganciclovir, cidofovir is not phosphorylated (and hence activated) by a viral kinase.
Notice how the administration of maintenance therapy is every other week! So you would take the pill bi-weekly!
Another key point is the main difference between Valcyte and Brincidofovir, which is the fact that Brincy is not phosphorylated by the virus. So it does not require activation on the part of the virus to incorporate (embed) itself into the viral DNA. The implication here is that Brincy would be less susceptible to drug resistance in the event of viral DNA mutation. Because when the genes are mutated, then activation on the part of the virus may not occur. At least, that's my understanding of it.
I don't believe that Valcyte's anti-inflammatory effects are what ultimately resolve the core problem with ME/CFS folks. That may treat symptoms, but not the root, which is viral DNA replication. Brincy seems to mitigate viral DNA replication in a superior, safer fashion when compared to Valcyte.
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