Baloxavir Marboxil (1)

Shiraishi C, et al. Journal of Infection and Chemotherapy, 2024, 30(3), 242-249.

This study systematically evaluated the efficacy and safety of baloxavir marboxil (BXM) compared to oseltamivir in both inpatients and outpatients with influenza virus infections. Data were collected from two randomized controlled trials (1624 outpatients) and two retrospective studies (874 inpatients). Experimental outcomes included mortality, hospitalization duration, adverse events, illness duration, and viral titers/RNA loads. BXM treatment in inpatients reduced mortality (p = 0.06) and significantly shortened hospitalization periods (p = 0.01). In outpatients, BXM demonstrated a lower incidence of adverse events (p = 0.03), greater reductions in viral titers and RNA loads (p < 0.001), and a trend toward shorter illness duration (p = 0.27). The findings support the clinical application of BXM as a safer and more effective antiviral for confirmed influenza virus infections across patient populations.

Jiang J, et al. Microbiology Spectrum, 2025, 13(7).

This multicenter retrospective study assessed baloxavir marboxil (BXM) versus oseltamivir in 117 kidney transplant recipients diagnosed with influenza. Patients received antiviral treatment either within or after 48 h of symptom onset. Clinical endpoints included time to symptom alleviation, fever duration, and viral clearance. BXM-treated patients demonstrated comparable overall symptom resolution and fever duration to oseltamivir; however, early treatment (≤48 h) with BXM was significantly associated with faster fever resolution (P = 0.030). Delayed BXM administration (>48 h) still resulted in improved symptom alleviation at 5 days (P = 0.001). These results highlight BXM's therapeutic potential in immunocompromised populations and inform optimized antiviral strategies for kidney transplant recipients.