In otherwise healthy patients, influenza treatment with baloxavir marboxil was found to be comparable, and on some efficacy measures, superior to neuraminidase inhibitors, according to a network meta-analysis published in Current Medical Research and Opinion.

For this investigation, a total of 22 randomized controlled trials were identified and included in the analysis to compare the safety and efficacy of baloxavir with other antivirals. Results showed that treatment with baloxavir was associated with significantly shorter time to alleviation of all symptoms vs zanamivir (difference in median time 19.96 hours, 95% CI, [3.23, 39.07]). In addition, “the time to cessation of viral shedding was significantly shorter for baloxavir than zanamivir and oseltamivir (47.00 hours; 95% CI [28.18, 73.86] and 56.03 hours [33.74, 87.86], respectively),” the authors reported.

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Moreover, baloxavir demonstrated a greater mean decline in virus titer from baseline to 24 hours compared with the other agents (zanamivir, oseltamivir and peramivir). The authors noted that other differences in efficacy outcomes were not found to be statistically significant.

Regarding safety, no significant differences were observed between baloxavir and other antivirals except a lower incidence of total drug-related adverse events associated with baloxavir vs oseltamivir and laninamivir.

Baloxavir marboxil (Xofluza; Genentech), a polymerase acidic (PA) endonuclease inhibitor, is currently approved as a single-dose regimen to treat acute uncomplicated influenza in patients who have been symptomatic for no more than 48 hours.

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