Comparison of Household Transmission of Influenza Virus From Index Patients Treated With Baloxavir Marboxil or Neuraminidase Inhibitors: A Health Insurance Claims Database Study

Komeda, Takuji; Takazono, Takahiro; Hosogaya, Naoki; Ogura, Eriko; Fujiwara, Masakazu; Miyauchi, Hideaki; Ajisawa, Yoshikazu; Iwata, Shimpei; Watanabe, Hideaki; Honda, Kei; Kitanishi, Yoshitake; Hara, Kanae; Mukae, Hiroshi

doi:10.1093/cid/ciaa1622

Cited by 13 publications

(20 citation statements)

References 14 publications

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“…Two studies using a large, Japanese health insurance claims database have compared household influenza transmission rates among families where the IP was treated with oseltamivir or an inhaled NAI [ 26 ] during the 2010–2011 season or with baloxavir or an NAI during the 2018–2019 season [ 28 ]. The first study found a significantly lower proportion of families with household transmission when the IP was treated with inhaled zanamivir (11.6%) or inhaled laninamivir (11.0%) compared with oseltamivir (14.3%) ( Table 2 ).…”

Section: Clinical Studiesmentioning

confidence: 99%

Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment

Hayden

Asher

Cowling

et al. 2021

Clinical Infectious Diseases

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Prompt antiviral treatment has the potential to reduce influenza virus transmission to close contacts, but rigorous data on the magnitude of treatment effects on transmission are limited. Animal model data indicate that rapid reductions in viral replication following antiviral treatment reduce the risk of transmission. Observational and clinical trial data with oseltamivir and other neuraminidase inhibitors indicate that prompt treatment of household index patients appears to reduce the risk of illness in contacts, although the magnitude of the reported effects has varied widely across studies. In addition, the potential risk of transmitting drug-resistant variants exists with all approved classes of influenza antivirals. A controlled trial examining baloxavir treatment efficacy to reduce transmission, including the risk of transmitting virus with reduced baloxavir susceptibility, is currently in progress. If reduced transmission risk is confirmed, modelling studies indicate that early treatment would have major epidemiologic benefits in seasonal and pandemic influenza.

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Section: Clinical Studiesmentioning

confidence: 99%

Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment

Hayden

Asher

Cowling

et al. 2021

Clinical Infectious Diseases

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“…Although several studies have suggested that treatment of ICs with an anti-influenza agent may reduce intra-familial transmission of influenza without the need for prophylaxis in non-infected individuals [ 12–16 ], the magnitude of the effect is variable and highly dependent on the time [ 17 ]. Komeda et al reported a significantly reduced incidence of intra-familial transmission with BXM treatment compared with OTV treatment in ICs by using a Japanese claims database [ 18 ]. In many of these studies, including Komeda et al’s [ 12 , 13 , 15 , 18 ], intra-familial infection was assumed to have occurred when the first day of influenza onset in the family was considered to be day 1 and when other family members developed influenza on days 3–.8.…”

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confidence: 99%

Comparison of Intra-Familial Transmission of Influenza Virus From Index Patients Treated With Baloxavir Marboxil or Oseltamivir Using an Influenza Transmission Model and a Health Insurance Claims Database

Miyazawa

Takazono

Hosogaya

et al. 2022

Clinical Infectious Diseases

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Background Influenza affects approximately a billion people globally, including >10 million Japanese individuals every year. Baloxavir marboxil (baloxavir [BXM]; a selective cap-dependent endonuclease inhibitor) is approved for influenza treatment in Japan. We compared the incidence of intra-familial transmission of influenza between BXM and oseltamivir (OTV) treatments using a simulation model. Methods Using the JMDC claims database, we identified index case (ICs) as the first family member diagnosed with influenza during the 2018–2019 influenza season, and classified the families into BXM or OTV group per the drug dispensed to ICs. Using a novel influenza intra-familial infection model, we simulated the duration of influenza infection in ICs based on agent-specific virus shedding periods. Intra-familial infections were defined as non-IC family members infected during the agent-specific viral shedding period in ICs. The virus incubation periods in the non-IC family members were considered to exclude secondary infections from potentially external exposure. The primary endpoint was proportion of families with intra-familial infections. For between-group comparisons, we used a multivariate logistic regression model. Results The median proportion of families with intra-familial transmission was 9.57% and 19.35% in the BXM (N=84,672) and OTV (N=62,004) groups, respectively. The multivariate odds ratio of 1.73 (2.5th-97.5th percentiles, 1.68-1.77) indicated a substantially higher incidence of intra-familial infections in the OTV group versus the BXM group. Subgroup analyses by ICs’ age category, virus type, and month of onset revealed similar trends favoring BXM. Conclusion BXM treatment of ICs may contribute to a greater reduction in intra-familial influenza transmission than OTV treatment.

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“…83 Moreover, if treatment were initiated within 24 hours, the impact would have increased by approximately 2-fold. 84…”

Section: Antivirals: Impact On Transmission and Prophylaxismentioning

confidence: 99%

Influenza Management During the COVID-19 Pandemic: A Review of Recent Innovations in Antiviral Therapy and Relevance to Primary Care Practice

Jones

Castro²,

Masters³

et al. 2021

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Seasonal influenza requires appropriate management to protect public health and resources. Decreasing the burden of influenza will depend primarily on increasing vaccination rates as well as prompt initiation of antiviral therapy within 48 hours of symptom onset, especially in the context of the current COVID-19 pandemic. A careful approach is required to prevent health services from being overwhelmed by a surge in demand that could exceed capacity. This review highlights the societal burden of influenza and discusses the prevention, diagnosis, and treatment of influenza as a complicating addition to the challenges of the COVID-19 pandemic. The importance of vaccination for seasonal influenza and the role of antiviral therapy in the treatment and prophylaxis of seasonal influenza, including the most up-to-date recommendations from the Centers for Disease Control and Prevention for influenza management, will also be reviewed.

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Comparison of Household Transmission of Influenza Virus From Index Patients Treated With Baloxavir Marboxil or Neuraminidase Inhibitors: A Health Insurance Claims Database Study

Cited by 13 publications

References 14 publications

Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment

Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment

Comparison of Intra-Familial Transmission of Influenza Virus From Index Patients Treated With Baloxavir Marboxil or Oseltamivir Using an Influenza Transmission Model and a Health Insurance Claims Database

Influenza Management During the COVID-19 Pandemic: A Review of Recent Innovations in Antiviral Therapy and Relevance to Primary Care Practice

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