AUTHOR=Liao Guichan , Xia Muye , Jiang Yuanhui , Chen Hongjie , Liao Wei , Peng Jie , Cai Shaohang 

TITLE=Prospective observational study of baloxavir marboxil in adults and adolescents with uncomplicated influenza from China

JOURNAL=Frontiers in Microbiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1292735

DOI=10.3389/fmicb.2023.1292735

ISSN=1664-302X

ABSTRACT=<sec><title>Introduction</title><p>There are limited data on the efficacy of baloxavir marboxil (baloxavir) versus oseltamivir in Chinese patients with influenza A.</p></sec><sec><title>Methods</title><p>This study is an observational real-world investigation encompassing 246 patients (baloxavir, <italic>n</italic> = 147; oseltamivir, <italic>n</italic> = 99) confirmed positive for influenza A. The choice between baloxavir and oseltamivir antiviral treatments was determined collaboratively by the clinician and the patient. A thorough comparative analysis was undertaken between the two groups, examining parameters such as the duration of fever and symptoms, viral load dynamics, lymphocyte changes, and enhancements in health-related quality of life (QoL).</p></sec><sec><title>Results</title><p>No significant differences were observed in demographic data between the two groups. The duration of fever was significantly shorter in the baloxavir group (<italic>P</italic> &lt; 0.001). However, the duration of symptoms was not significant different (<italic>P</italic> = 0.167). Multivariable Cox analysis showed the independent factors affecting duration of fever were baloxavir treatment (HR = 2.033, <italic>P</italic> &lt; 0.001), fever on day 1 (HR = 0.741, <italic>P</italic> = 0.010) and CRP level (HR = 1.009, <italic>P</italic> = 0.039). Moreover, sex (HR= 0.660, <italic>P</italic> = 0.019) and monocyte count (HR = 1.355, <italic>P</italic> = 0.018) were independent factors affecting the duration of symptoms. No significant difference in change of health-related quality of life (<italic>P</italic> &gt; 0.05), positive rate of viral antigen on day 3 (<italic>P</italic> = 0.477) between the two groups. Remarkably, a mutation was observed in one case on the third-day after baloxavir treatment compared with first-day, from cysteine to serine at position 384 of the PA subunit.</p></sec><sec><title>Conclusion</title><p>In the clinical setting, baloxavir demonstrated comparable clinical benefits to oseltamivir, establishing its efficacy as an effective antiviral therapy for Chinese patients with influenza.</p></sec>