15 Jul Prophylaxis against Flu in Household Contacts with XOFLUZA™ – Baloxavir Marboxil

MedicalResearch.com Interview with:

Dr. Hayden

Frederick Hayden MD
Stuart S Richardson Professor Emeritus of Clinical Virology
Professor Emeritus of Medicine
Division of Infectious Diseases and International Health
University of Virginia

 MedicalResearch.com: What is the background for this study?

Response: Although primary prevention approach for influenza infections is vaccination, vaccine efficacy is incomplete and uptake rates are variable in the population. Preventing people who have been exposed to someone with influenza from developing the disease is an important way to prevent its rapid spread, reduce the disruption to peoples’ lives and, in some cases, reducing the risk of serious illness or even death.  Prior studies have shown that antivirals like oseltamivir and inhaled zanamivir can reduce the risk influenza illness in those exposed.

The BLOCKSTONE study was designed to assess the efficacy of postexposure prophylaxis with a single oral dose of baloxavir for the preventing influenza in household contacts. This antiviral drug was approved first in 2018 for treatment of adults with uncomplicated influenza. 

MedicalResearch.com: What are the main findings?

Response: Baloxavir reduced the onset of laboratory-confirmed clinical influenza in household contacts by 86%. In overall modified intention-to-treat population, clinical influenza was 1.9% (7 of 374) and 13.6% (51 of 375) in baloxavir and placebo groups, respectively, and the adjusted risk ratio was 0.14 [95% CI: 0.06-0.30, p<0.001].  Among children younger than 12 years of age, baloxavir also led to 73% lower risk of laboratory-confirmed influenza; 4.2% (3 of 71) and 15.5% (11 of 71) for baloxavir and placebo group, respectively. Protection against clinical influenza was also seen in higher-risk contacts and those not immunized with influenza vaccine.   

MedicalResearch.com: What should readers take away from your report? 

Response: Antiviral chemoprophylaxis is an important option to reduce the risk of influenza illness in close contacts of ill persons during influenza outbreaks.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Outbreaks of influenza virus infection occur in hospitals and long-term care facilities, often with severe consequences.  The efficacy of baloxavir in these non-household settings warrants careful study. 

Citation:

Baloxavir Marboxil for Prophylaxis against Influenza in Household Contacts

Hideyuki Ikematsu, M.D., Frederick G. Hayden, M.D., Keiko Kawaguchi, M.S., Masahiro Kinoshita, M.Pharm., Menno D. de Jong, M.D., Nelson Lee, M.D., Satoru Takashima, M.S., Takeshi Noshi, M.S., Kenji Tsuchiya, M.S., and Takeki Uehara, Ph.D
July 8, 2020
DOI: 10.1056/NEJMoa1915341 

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Last Updated on July 15, 2020 by Marie Benz MD FAAD