Baloxavir Marboxil for Prophylaxis against Influenza in Household Contacts

Ikematsu, Hideyuki; Hayden, Frederick G.; Kawaguchi, Keiko; Kinoshita, Masahiro; Jong, Menno D. de; Lee, Nelson; Takashima, Shinogu; Noshi, Takeshi; Tsuchiya, Kenji J.; Uehara, Takeki

doi:10.1056/nejmoa1915341

Cited by 99 publications

(88 citation statements)

References 31 publications

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“…Ikematsu et al reported the postexposure prophylactic efficacy of baloxavir in preventing influenza in household contacts of patients with influenza [18]. However, this study did not indicate the effect of the antiviral drugs administered to index patients on disease transmission.…”

Section: Discussionmentioning

confidence: 63%

Efficacy of baloxavir marboxil on household transmission of influenza infection

Umemura

Mutoh

Kawamura

et al. 2020

J Pharm Health Care Sci

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Background Baloxavir marboxil (baloxavir) is a new anti-influenza virus agent that is comparable to oseltamivir phosphate (oseltamivir). Since the efficacy of baloxavir in preventing household transmission of influenza is not well established, we compared the secondary household influenza virus transmission rates between patients on baloxavir vs oseltamivir. Methods Between October 2018 and March 2019, we enrolled index patients (diagnosed with influenza and treated with baloxavir or oseltamivir) and household members. The secondary attack rate of household members was compared between index patients treated with baloxavir vs oseltamivir. Risk factors of household transmission were determined using multivariate logistic analyses. Results In total, 169 index patients with influenza type A were enrolled. The median age was 27.0 (interquartile range; 11–57) years. The number of index patients treated with baloxavir and oseltamivir was 49 and 120, respectively. The secondary attack rate was 9.0% (95% confidence interval [CI]: 4.6–15.6) in the baloxavir group and 13.5% (95% CI: 9.8–17.9) in the oseltamivir group. In the multivariate analysis, independent risk factors were 0–6 years of age (odds ratio [OR] 2.78, 95% CI: 1.33–5.82, p < 0.01) and not being on baloxavir treatment. (OR: 0.63, 95% CI: 0.30–1.32, p = 0.22). Conclusion The household secondary attack rate of influenza was comparable in patients treated with baloxavir vs oseltamivir. Therefore, baloxavir can be used as an alternative therapy to oseltamivir in reducing household transmission of influenza. Trial registration Patients in this study were retrospectively registered. https://www.tosei.or.jp/clinical/pdf/2_influenza.pdf.

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Section: Discussionmentioning

confidence: 63%

Efficacy of baloxavir marboxil on household transmission of influenza infection

Umemura

Mutoh

Kawamura

et al. 2020

J Pharm Health Care Sci

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“…However, <10% of our survey respondents reported prescribing baloxavir. Although the emergence of baloxavir‐resistant influenza virus has been reported recently, 47 the prophylactic effect of baloxavir on household contacts has also been reported 48 . Further studies are desired to uncover the optimum use of anti‐influenza drugs among cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of the current situation regarding influenza vaccination according to medical oncologists in Japan

et al. 2020

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“…30 In a recent post-exposure prophylactic report, BXM demonstrated efficacy in preventing influenza infections in household contacts of patients with influenza. 31 The US Food and Drug Administration approved BXM on 24…”

Section: Activity Of Bxm Against Influenza Viruses In Clinical Studiesmentioning

confidence: 99%

Fitness of influenza A and B viruses with reduced susceptibility to baloxavir: A mini‐review

Abed

Saim-Mamoun

Boivin

2020

Reviews in Medical Virology

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Neuraminidase inhibitors (NAIs), that currently include oseltamivir (Tamiflu ® ), zanamivir (Relenza ® ), peramivir (Rapivab ® ) and laninamivir (Inavir ® ), constitute an important class of antivirals recommended against seasonal influenza A and B infections. NAIs target the surface NA protein whose sialidase activity is responsible for virion release from infected cells. Because of their pivotal role in the transcription/translation process, the polymerase acidic (PA) and polymerase basic 1 and 2 (PB1 and PB2, respectively) internal proteins also constitute targets of interest for the development of additional anti-influenza agents. Baloxavir marboxil (BXM), an inhibitor of the cap-dependent endonuclease activity of the influenza PA protein, was approved in the United States and Japan in 2018. Baloxavir acid (BXA), the active compound of BXM, demonstrated a potent in vitro activity against different types/subtypes of influenza viruses including seasonal influenza A/B strains as well as avian influenza A viruses with a pandemic potential. A single oral dose of BXM provided virological and clinical benefits that were respectively superior or equal to those displayed by the standard (5 days, twice daily) oseltamivir regimen. Nevertheless, BXM-resistant variants have emerged at relatively high rates in BXM-treated children and adults. Consequently, there is a need to study the fitness (virulence and transmissibility) characteristics of mutants with a high potential to emerge as such variants can compromise the clinical usefulness of BXM.The purpose of this manuscript is to review the fitness properties of influenza A and B isolates harbouring mutations of reduced susceptibility to BXA.

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Baloxavir Marboxil for Prophylaxis against Influenza in Household Contacts

Cited by 99 publications

References 31 publications

Efficacy of baloxavir marboxil on household transmission of influenza infection

Efficacy of baloxavir marboxil on household transmission of influenza infection

Surveillance of the current situation regarding influenza vaccination according to medical oncologists in Japan

Fitness of influenza A and B viruses with reduced susceptibility to baloxavir: A mini‐review

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