Phoenix Rising - Cort Johnson's Column
...Presenting complex chronic fatigue syndrome (ME/CFS) research in a way we can all understand.
Friday, November 4th, 2011:
The ‘X’ Drug For ME/CFS? CMX001 Promises Help
Dr. Ronald Glaser - Chronic Fatigue Syndrome and the Pathophysiology of EBV Infection
by Cort Johnson
The big news on the treatment scene from Dr Peterson is CMX001 – a new drug developed by Chimerix to treat herpesviruses and other pathogens which may come on the scene in the next few years. Chimerix is a relatively new pharmaceutical company built around a unique drug delivery system they believe significantly increases these drugs’ effectiveness and reduces their side effects.
Chimerix came to Dr. Peterson because they knew he was treating herpesvirus infection in ME/CFS patients and he is beginning a trial study of the drug using his present patients. Chimerix is not interested in CFS per se and patients do not need to fit X definition of the disease in order to be in the study – they simply need to have a documented herpes virus infection.
The ‘Hammer’ Gets Stronger and Safer - CMX001 appears to be a safer and more effective version of cidofovir, otherwise known as Vistide. Vistide (cidofovir) is a powerful drug little used by ME/CFS physicians because it requires intravenous injections and can cause acute kidney damage.
Chimerix’s great innovation is to modify Vistide so that that it looks like a naturally occurring by-product of fat cells – causing the body to easily take it up into its tissues. Chimerix’s new ‘packaging’ process is innovative enough that the resulting drug is considered a ‘new chemical entity’ and thus is protected by patent laws. (Chimerix’s Phospholipid Intramembrane Microfluidization (PIM) Conjugate method is protected by 21 patents.)
CMX001’s two big plusses are ‘increased efficacy’ and ‘reduced toxicity’. CMX001 appears not to affect the kidneys at all and its only toxicity worries appear to involve the gastrointestinal system which, Chimerix reports, are ‘easily monitored and rapidly reversible’. Nor is intravenous administration a problem…Chimerix comes in the form of a pill….
Chimerix believes its new packaging process will ‘dramatically change the way certain viral diseases are treated. Its website states CMX001 is not just a little bit more, or even moderately more, but ‘much more potent’ than the original drug (Vistide) in in vitro studies against a wide variety of viruses. Vistide, referred in a tongue in cheek manner on the PR Forums as ‘the Hammer’, was already one of the more effective drugs against herpesviruses. Physicians were reluctant to administer it because it required IVs and because of its potential side effects. Having this drug available in a safer, more effective form could be a big boon for physicians treating herpesvirus infections.
From Chimerix’s website:
"Based on data obtained to date, CMX001’s profile may allow physicians to treat patients much earlier and more effectively in the disease course, as opposed to many current therapies where the risks of serious and harmful side effects delays treatment."
That makes CMX001 sound almost made to order for herpesvirus infected people with ME/CFS who often take large doses of antivirals for long periods of time (http://www.chimerix-inc.com/about-ch…ry/commitment/). Its possible that some ME/CFS patients who can’t tolerate antivirals in the doses needed or don’t respond well to them might very well respond well to CMX001. CMX001’s increased efficacy might also make it more effective at getting at the ‘buried’ herpesviruses infections that often require such long treatment regimes in ME/CFS.….
An Effective Central Nervous System Antiviral? - Research into CMX001 is just beginning, but thus far two studies suggest it may be more effective in getting at hard to reach central nervous system infections. In one study CMX001 was fifty times more effective in vitro against herpes simplex viruses than acyclovir or cidofovir and was shown to reach deep into the central nervous system (http://www.ncbi.nlm.nih.gov/pubmed/20923374).
CMX001 is also being touted as possibly the first effective drug able to treat progressive multifocal leukoencephalopathy (PML), a frequently fatal brain disease in immunodeficient patients, caused by the Polyomavirus JC (http://www.ncbi.nlm.nih.gov/pubmed/20923374).
Not Just Herpesviruses - On their homepage, Chimerix emphasizes the ‘broad antiviral’ spectrum that the drug treats and they aren’t kidding. CMX001 was originally developed to combat smallpox, not herpesviruses; it was only later Chimerix realized it possibly has a broad spectrum antiviral on its hands. (Chimerix was recently awarded a $36 million NIH grant (10 years of ME/CFS research!) to investigate CMX001’s effectiveness against smallpox). Thus far, Chimerix has been shown to be ‘much more effective’ against multiple double-stranded DNA viruses (such as variola [smallpox], cytomegalovirus, BK virus, vaccinia, ectromelia, adenovirus and Epstein-Barr virus and cowpox viruses) in laboratory trials.
Chimerix, founded in 2002, is a young company and CMX001 is its first product. It will take time to determine how effective Chimerix is in patients but on the face of it it appears to be the most promising drug for CFS since Ampligen came on the scene over 20 years ago.
This was taken from the Treatment section of “Looking Forward: Dr. Peterson on ME/CFS Research, Treatment and Hope for the Future”. This article was derived from notes I took after a talk with Dr. Peterson; the views enclosed hopefully reflect the essence of the talk but any mistakes, of course, are mine. Thanks to Corinne for arranging a meeting with Dr. Peterson.
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