Rationale: Classical antiviral therapies target viral proteins and are consequently subject to resistance. To counteract this limitation, alternative strategies have been developed that target cellular factors. We hypothesized that such an approach could also be useful to identify broad-spectrum antivirals. The influenza A virus was used as a model for its viral diversity and because of the need to develop therapies against unpredictable viruses as recently underlined by the H1N1 pandemic. Gene-expression signature-based screening identified broadly effective influenza A antivirals. Midodrine showed great results in inhibiting viral growth and was the most suited to confirm its efficacy in vivo. The main objective of the study is to assess the efficacy of midodrine taken at usual recommended dose (7.5mg/day) versus no treatment on viral replication kinetics of virus Influenza A. Secondary objectives: evaluation of the number of patients with a normalized viral load 2, 3 5 and 7 days post-treatment; description of the anti-viral efficacy of midodrine defined as the delay to obtain a prolonged negativity of viral RNA; description of the tolerance of midodrine, evaluation of the clinical response to study treatment; evaluation of the dynamic of viral replication; analysis of the frequency of emergence of mutants and associated resistance. Methods: This is a multicenter, randomized, open-label study comparing patients aged 18 to 65 years infected by influenza A virus. Nasopharyngeal washing will be performed at day 0 (randomization), 2, 3, 5 to show the viral replication evolution. 161 patients will be randomized as follows : * Arm 1 : Midodrine, 2.5 mg, 3 times a day * Arm 2 : No treatment The recruitment is performed by general practitioners in the Lyon area.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
79
Midodrine 2.5 mg orally 3 times daily, 5 day-treatment.
Cabinet Médical du Dr ALIBERT
Bron, France
Cabinet Médical du Dr CURE
Bron, France
Centre d'Investigation Clinique de Lyon
Bron, France
Cabinet du Dr DAHAN
Decine Charpieu, France
Cabinet du Dr MADELON
Décine Charpieu, France
Cabinet Médical du Dr HILLION
Comparison of viral replication kinetics between the 2 arms
Comparison of the viral load slopes for 7 days post-study treatment start. Viral load will be measured at day 0, 2, 3, 5, and 7
Time frame: 7 days
Percentage of patients with a normalized viral load
A normal viral load is defined as a value below the positive threshold of 3 in RT-qPCR at day 2, 3, 5 and 7
Time frame: 7 days
Duration and severity of flu symptoms
Time frame: 7 days
Frequency, duration and level of replication of the virus in nose samples
Time frame: 7 days
Viral resistance and decrease of sensitivity of collected strains
Time frame: 7 days
Tolerance of midodrine : incidence of adverse effects
Side effects will be checked at each visit and reported for the entire study timeframe.
Time frame: 7 days
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Lyon, France
Cabient Médical du Dr PIOS
Lyon, France
Cabinet du Dr ATTALI
Lyon, France
Cabinet du Dr COUTY
Lyon, France
Hôpital D'Instruction des Armées Desgenettes
Lyon, France
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