Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Infectious Disease Research Center at Niigata University in Myanmar (IDRC), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Infectious Disease Research Center at Niigata University in Myanmar (IDRC), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Antiviral Res. 2022 May;201:105310. doi: 10.1016/j.antiviral.2022.105310. Epub 2022 Mar 28.
Data on the clinical effectiveness of the novel anti-influenza drug baloxavir marboxil (baloxavir) in children remain limited. We conducted an observational study to compare the duration of fever and symptoms between baloxavir- and oseltamivir-treated children infected with influenza A and B. In total, 159 outpatients with influenza A(H1N1)pdm09 or B/Victoria-lineage infections, aged <19 years, during the 2019-2020 influenza season in Japan were enrolled and assessed the duration of fever and symptoms using the Kaplan-Meier method and a multivariate Cox proportional hazard regression model. Polymerase acidic (PA) variants were examined before and after baloxavir treatment. In the multivariable analysis, the duration of fever and symptoms was unaltered between the A(H1N1)pdm09 (n = 116) and B/Victoria-lineage (n = 43) groups. Conversely, the fever duration was marginally longer in the oseltamivir-treated group (n = 59) than in the baloxavir group (n = 100) (hazard ratio (HR) = 0.67, p = 0.05); however, the duration of symptoms was unaltered between the two groups (HR = 0.74, p = 0.11). No patient presented PA reduced susceptibility marker(s) before baloxavir treatment in the analyzed groups. The PA/E23K variant was detected in one case (1.5%, 1/66) of A(H1N1)pdm09 after baloxavir treatment. One case (2.0%, 1/50) of A(H1N1)pdm09 with an N295S substitution in neuraminidase was detected following oseltamivir treatment. These results suggested that the duration of fever was likely to be shorter with baloxavir than with oseltamivir, but the difference between influenza A (H1N1)pdm09 and B/Victoria-lineage was unclear. It is important to continue evaluating the clinical effectiveness of baloxavir and monitoring its drug susceptibility to the influenza virus.
有关新型抗流感药物巴洛沙韦（baloxavir）在儿童中的临床疗效的数据仍然有限。我们进行了一项观察性研究，比较了流感 A 和 B 感染的接受巴洛沙韦和奥司他韦治疗的儿童的发热和症状持续时间。在日本，2019-2020 流感季节期间，共纳入了 159 名年龄<19 岁的甲型流感 A（H1N1）pdm09 或乙型流感 B/维多利亚谱系感染的门诊患者，使用 Kaplan-Meier 方法和多变量 Cox 比例风险回归模型评估发热和症状持续时间。在接受巴洛沙韦治疗前后检查聚合酶酸性（PA）变体。在多变量分析中，甲型流感 A（H1N1）pdm09 组（n=116）和乙型流感 B/维多利亚谱系组（n=43）之间发热和症状持续时间没有改变。相反，奥司他韦治疗组（n=59）的发热持续时间比巴洛沙韦组（n=100）略长（风险比（HR）=0.67，p=0.05）；然而，两组之间的症状持续时间没有改变（HR=0.74，p=0.11）。在分析的各组中，没有患者在接受巴洛沙韦治疗前出现 PA 降低的耐药标志物。在接受巴洛沙韦治疗后，甲型流感 A（H1N1）pdm09 中有 1 例（1.5%，1/66）检测到 PA/E23K 变体。在奥司他韦治疗后，有 1 例（2.0%，1/50）甲型流感 A（H1N1）pdm09 检测到神经氨酸酶 N295S 取代。这些结果表明，发热持续时间可能更短巴洛沙韦比奥司他韦，但甲型流感 A（H1N1）pdm09 和乙型流感 B/维多利亚谱系之间的差异尚不清楚。继续评估巴洛沙韦的临床疗效并监测其对流感病毒的药物敏感性非常重要。
