Efficacy of baloxavir marboxil on household transmission of influenza infection
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(2020) 6:21
RESEARCH ARTICLE
Open Access
Efficacy of baloxavir marboxil on household transmission of influenza infection Takumi Umemura1,2* , Yoshikazu Mutoh2, Takato Kawamura1, Masayuki Saito1, Takahito Mizuno1, Aiko Ota1, Koji Kozaki1, Tetsuya Yamada1, Yoshiaki Ikeda3 and Toshihiko Ichihara2
Abstract 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. Keywords: Baloxavir marboxil, Oseltamivir phosphate, Secondary attack rate, Influenza
Introduction One of the major ways of transmitting the influenza virus is through household contact [1]. As the 2009 influenza A (H1N1) virus spread globally, many countries implemented mitigation policies that included home * Correspondence: [email protected] 1 Department of Pharmacy, Tosei General Hospital, 160, Nishi oiwakecho, Seto, Aichi 489-8642, Japan 2 Department of Infection and Prevention, Tosei General Hospital, 160, Nishi oiwakecho, Seto, Aichi 489-8642, Japan Full list of author information is available at the end of the article
isolation of persons with confirmed H1N1 infection [1]. This increased the risk of infection to other household members. The risk factors for H1N1 transmission (to other household members) include the presence of young children in the household, household size, and use of antiviral agents, such as neuraminidase inhibitors [oseltamivir phosphate (oseltamivir), zanamivir hydrate (zanamivir), laninamiv
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