Baloxavir Marboxil shows promise in reducing the spread of household flu

Baloxavir Marboxil shows promise in reducing the spread of household flu

One dose of the antiviral baloxavir marboxil reduces the chance of transmitting the influenza virus to family members by about 30%, according to research in the New England Journal of Medicine.

In the study, a global Phase III trial of baloxavir marboxil (brand name Xofluza), led by University of Michigan epidemiologist Arnold Monto, researchers found that the drug significantly slowed viral shedding that infects close contacts.

In the study, called the CenterStone study, the study included 1,457 influenza-positive patients ages 5 to 64 and 2,681 household contacts. Patients were randomly assigned to receive either baloxavir or placebo, and their contacts were followed to detect influenza transmission.

“There has always been a question that antivirals, which are known to shorten the duration of influenza when treated early, also prevent the spread of influenza,” said Monto, a longtime vaccine and respiratory responder to the Centers for Disease Control and Prevention and the Federal Drug Administration.

"We have drugs that have been treating influenza for many years, but it was unclear whether there was a reduction in transmission from the sick person. It was also not clear whether this was because no study was done specifically to look for a reduction in spread or to address it."

“Our study was designed to directly assess whether this meant we could finally determine that transmission could be reduced, and we were finally able to demonstrate that it was.”

Co-author Adam Lauring, chief of the Division of Infectious Diseases at UM Medical School, said the results suggest great potential for reducing flu incidence.

This was a really exciting study to work on. It highlights how we may be able to use an antiviral to help not only our patients, but also our households and larger communities by preventing influenza transmission. It could change how we approach future influenza outbreaks. “

Adam Lauring, Professor of Internal Medicine and Microbiology and Immunology

Since other flu antivirals require a daily dose for five days and baloxavir is a single dose, this may mean greater use of the treatment "as it means not only protecting yourself from complications, but also protecting others," said Monto, professor emeritus of epidemiology and global public health at the UM School of Public Health and the co-director of the Michigan Center for Respiratory Viruses and Response.

"These results expand the rationale for treating influenza patients with antiviral. It's a twofold thing: shortening the duration of the disease, which can also prevent complications leading to hospitalization or death while reducing transmission."

An antiviral that reduces viral shedding also brings promise for combating the spread of bird flu, Monto said. While it has not been studied for avian influenza in either birds or cattle, researchers have learned from laboratory studies that baloxavir also prevents this type of influenza from replicating.

In addition to funding from trial sponsor and manufacturer Roche, the research was funded by the Center for the Biomedical Advanced Research and Development Authority, part of the Department of Health and Human Services.

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