Fomivirsen

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Fomivirsen

Chemical structure of Fomivirsen

Fomivirsen is an antisense oligonucleotide used in the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome (AIDS). It was the first antisense drug to be approved by the Food and Drug Administration (FDA) in 1998.

Mechanism of Action

Fomivirsen is designed to bind to the mRNA of the cytomegalovirus (CMV), thereby inhibiting the translation of viral proteins necessary for the virus to replicate. By targeting the mRNA, fomivirsen prevents the synthesis of proteins that are essential for the virus's life cycle, effectively reducing the viral load in the retina.

Administration

Fomivirsen is administered via intravitreal injection, which involves injecting the drug directly into the vitreous humor of the eye. This method of administration allows for high concentrations of the drug to be delivered directly to the site of infection, minimizing systemic exposure and potential side effects.

Clinical Use

Fomivirsen is specifically indicated for the treatment of CMV retinitis in patients with AIDS, particularly in cases where other treatments have failed or are not tolerated. CMV retinitis is a serious condition that can lead to blindness if not treated effectively.

Side Effects

Common side effects of fomivirsen include ocular inflammation, increased intraocular pressure, and retinal detachment. Patients receiving fomivirsen should be monitored closely for these adverse effects.

Discontinuation

With the advent of more effective antiretroviral therapy (ART) for HIV/AIDS, the incidence of CMV retinitis has decreased significantly. As a result, the use of fomivirsen has declined, and it is no longer widely available.

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Contributors: Prab R. Tumpati, MD