Department of Pharmacy, Yale New Haven Hospital, Department of Pharmacy Services, New Haven, CT, USA.
Janssen Scientific Affairs, Raritan, NJ, USA.
J Antimicrob Chemother. 2020 Oct 1;75(10):3015-3022. doi: 10.1093/jac/dkaa252.
To date, clinical trials evaluating baloxavir have excluded patients hospitalized with influenza infection and therefore this study sought to evaluate the efficacy of baloxavir in inpatients with influenza A.
This study was a multicentre, retrospective chart review of adult patients admitted to the hospital within the Yale New Haven Health System who received oseltamivir or baloxavir for the treatment of influenza A. Patients were screened for inclusion between January 2018 and April 2018 in the oseltamivir group, while patients in the baloxavir group were screened for inclusion between January 2019 and April 2019. Influenza A diagnosis was confirmed by RT-PCR using a nasopharyngeal swab specimen.
Of the 2392 patients assessed, 790 met the inclusion criteria. There were 359 patients who received baloxavir and 431 patients who received oseltamivir. Patients who received baloxavir were younger compared with those who received oseltamivir [median = 69 (IQR = 57-81) years versus 77 (IQR = 62-86) years; P < 0.001]. Patients who received baloxavir had no significant difference in hospital length of stay [median = 4 (IQR = 3-6) days versus 5 (IQR = 3-6) days; P = 0.45] or 30 day all-cause mortality [12 (3.3%) versus 26 (6%); P = 0.079] compared with those who received oseltamivir. However, patients who received baloxavir had a significantly faster time to hypoxia resolution [median = 51.7 (IQR = 25.3-89.3) h versus 72 (IQR = 37.5-123) h; P < 0.001].
The results of this study support the use of baloxavir for the treatment of influenza A in hospitalized patients with the potential benefit of a faster time to resolution of hypoxia.
迄今为止，评估巴洛沙韦的临床试验排除了因流感感染住院的患者，因此本研究旨在评估巴洛沙韦在甲型流感住院患者中的疗效。
本研究为一项多中心、回顾性病历审查，纳入了 2018 年 1 月至 2018 年 4 月期间在耶鲁纽黑文健康系统住院并接受奥司他韦治疗的流感 A 成年患者，以及 2019 年 1 月至 2019 年 4 月期间接受巴洛沙韦治疗的流感 A 成年患者。使用鼻咽拭子标本通过 RT-PCR 确认流感 A 诊断。
在评估的 2392 名患者中，有 790 名符合纳入标准。其中 359 名患者接受了巴洛沙韦治疗，431 名患者接受了奥司他韦治疗。接受巴洛沙韦治疗的患者比接受奥司他韦治疗的患者年龄更小[中位数=69（IQR=57-81）岁比 77（IQR=62-86）岁；P<0.001]。接受巴洛沙韦治疗的患者与接受奥司他韦治疗的患者相比，住院时间[中位数=4（IQR=3-6）天比 5（IQR=3-6）天；P=0.45]或 30 天全因死亡率[12（3.3%）比 26（6%）；P=0.079]无显著差异。然而，接受巴洛沙韦治疗的患者缺氧缓解时间明显更快[中位数=51.7（IQR=25.3-89.3）小时比 72（IQR=37.5-123）小时；P<0.001]。
本研究结果支持将巴洛沙韦用于治疗住院流感 A 患者，其潜在益处是更快地缓解缺氧。
