Abstract
Baloxavir marboxil is a new anti-influenza drug, but data on the clinical efficacy of a combination treatment of baloxavir and peramivir is scarce. We conducted a single-center retrospective analysis comparing the mortality of a combination of baloxavir and peramivir (B & P, n = 10) and peramivir without baloxavir (P-mono, n = 132) in hospitalized adults with influenza A between 2011 and 2019 in Yokohama City, Japan. Sequencing analysis was conducted in the B & P group to check the I38 mutation in polymerase acidic protein which is associated with baloxavir resistance. The 30-day mortality rates were 0 (0%) in the B & P group and 6 (4.5%) in the P-mono group, respectively, which was not statistically significant. The I38 mutation was not detected before and after the combination treatment. A combination treatment of baloxavir and peramivir might be more effective than peramivir without baloxavir and prevent the emergence of baloxavir resistance in hospitalized adults with influenza A.
Keywords:
Baloxavir; Combination; Influenza; Peramivir.
MeSH terms
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Acids, Carbocyclic / administration & dosage
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Acids, Carbocyclic / pharmacology
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Acids, Carbocyclic / therapeutic use*
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Administration, Oral
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Aged, 80 and over
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Antiviral Agents / administration & dosage
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Antiviral Agents / pharmacology
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Antiviral Agents / therapeutic use*
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Dibenzothiepins / administration & dosage
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Dibenzothiepins / pharmacology
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Dibenzothiepins / therapeutic use*
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Drug Resistance, Viral
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Drug Therapy, Combination
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Female
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Guanidines / administration & dosage
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Guanidines / pharmacology
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Guanidines / therapeutic use*
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Humans
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Influenza A virus / drug effects
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Influenza A virus / isolation & purification*
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Influenza, Human / drug therapy
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Influenza, Human / mortality*
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Japan
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Male
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Morpholines / administration & dosage
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Morpholines / pharmacology
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Morpholines / therapeutic use*
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Pyridones / administration & dosage
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Pyridones / pharmacology
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Pyridones / therapeutic use*
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Retrospective Studies
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Triazines / administration & dosage
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Triazines / pharmacology
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Triazines / therapeutic use*
Substances
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Acids, Carbocyclic
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Antiviral Agents
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Dibenzothiepins
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Guanidines
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Morpholines
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Pyridones
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Triazines
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baloxavir
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peramivir