Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 1738610, Japan.
Nezu Clinic, Tokyo 1740042, Japan.
Medicina (Kaunas). 2023 Aug 25;59(9):1543. doi: 10.3390/medicina59091543.
: Baloxavir marboxil is a novel cap-dependent endonuclease inhibitor prescribed for influenza treatment. Unlike neuraminidase inhibitors like oseltamivir, which impair viral release from infected host cells, baloxavir blocks influenza virus proliferation by inhibiting viral mRNA transcription. This study aimed to compare the effectiveness of baloxavir and oseltamivir for the treatment of early childhood influenza. : Of 1410 patients diagnosed with influenza between 2015 and 2018 at a Japanese primary care outpatient clinic, 1111 pediatric patients aged 0-6 years who were treated with baloxavir ( = 555) or oseltamivir ( = 556) were enrolled retrospectively. The following clinical factors were compared between patients treated with baloxavir and oseltamivir: age, sex, time from fever onset to drug administration (<24 h or 24-48 h), time from drug administration to fever reduction, influenza type (A or B), and influenza vaccination before disease onset. The duration of the fever, which was used as an index of clinical effectiveness, was compared using the log-rank test. Clinical factors associated with fever duration were determined using multivariate logistic regression analysis. : Median age (3.0 vs. 2.5 years), influenza type A (99% vs. 47%), median duration from drug administration to fever resolution (1 day vs. 2 days), and influenza vaccination (done, 41% vs. not done, 65%) were significantly different between the baloxavir and oseltamivir groups ( < 0.001). The number of patients with a fever duration of one day was 553 (99.6%) in the baloxavir group and 6 (1.1%) in the oseltamivir group ( < 0.001). Baloxavir use was only significantly associated with fever duration in the multivariate analysis (odds ratio 50,201, < 0.001). Apparent adverse effects were not observed in the baloxavir-treated group. : Baloxavir treatment resulted in a shorter fever duration than oseltamivir treatment in early childhood influenza.
巴洛沙韦玛波西利是一种新型的帽依赖性内切酶抑制剂，用于流感的治疗。与神经氨酸酶抑制剂（如奥司他韦）不同，后者通过破坏感染宿主细胞中的病毒释放来发挥作用，巴洛沙韦通过抑制病毒 mRNA 转录来阻断流感病毒的增殖。本研究旨在比较巴洛沙韦和奥司他韦治疗儿童早期流感的效果。
在日本的一家初级保健门诊中，对 2015 年至 2018 年间诊断为流感的 1410 例患者进行了回顾性分析，共纳入了 1111 例年龄在 0-6 岁的儿科患者，这些患者接受了巴洛沙韦（n = 555）或奥司他韦（n = 556）治疗。比较了接受巴洛沙韦和奥司他韦治疗的患者的以下临床因素：年龄、性别、从发热到用药的时间（<24 h 或 24-48 h）、从用药到退热的时间、流感类型（A 型或 B 型）和疾病发作前的流感疫苗接种情况。使用对数秩检验比较了发热持续时间（作为临床疗效的指标）。使用多变量逻辑回归分析确定与发热持续时间相关的临床因素。
中位年龄（3.0 岁 vs. 2.5 岁）、A型流感（99% vs. 47%）、从用药到退热的中位时间（1 天 vs. 2 天）和流感疫苗接种情况（接种，41% vs. 未接种，65%）在巴洛沙韦组和奥司他韦组之间存在显著差异（<0.001）。巴洛沙韦组发热持续时间为 1 天的患者有 553 例（99.6%），奥司他韦组有 6 例（1.1%）（<0.001）。在多变量分析中，仅发现使用巴洛沙韦与发热持续时间显著相关（比值比 50.201，<0.001）。在巴洛沙韦治疗组未观察到明显的不良反应。
在儿童早期流感中，巴洛沙韦治疗的发热持续时间短于奥司他韦治疗。
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