Influenza Antiviral Medications: Summary for Clinicians | CDC - CDC

In October 2019, FDA approved an indication for baloxavir treatment of acute uncomplicated influenza within 2 days of illness onset in people 12 years and older at high risk of developing influenza-related complications, based upon the findings of a clinical trial (Ison, 2020). In this clinical trial of early initiation of antiviral treatment for uncomplicated influenza in highrisk patients, baloxavir was superior to placebo and had similar overall efficacy to oseltamivir in the time to alleviation of symptoms. For patients with influenza B virus infection, baloxavir significantly reduced the median time to improvement of symptoms compared with oseltamivir by more than 24 hours.

For patients with influenza B virus infection, baloxavir significantly reduced the median time to improvement of symptoms compared with oseltamivir by more than 24 hours. However, there are no available data for baloxavir treatment of influenza in pregnant people, immunocompromised people, or in people with severe influenza who are not hospitalized.

In August 2022, FDA expanded approval of baloxavir for treatment of acute uncomplicated influenza within 2 days of illness onset in children aged 5 years to <11 years who are otherwise healthy package insert XOFLUZA [963 KB, 22 pages]. This was based upon the secondary clinical outcomes of a randomized clinical trial of baloxavir versus oseltamivir for treatment of uncomplicated influenza in children aged 1 year to <12 years (Baker, 2021).

A randomized clinical trial reported that combination neuraminidase inhibitor (primarily oseltamivir) and baloxavir for treatment of hospitalized influenza patients aged ≥12 years did not result in superior clinical benefit (time to clinical improvement) compared with neuraminidase inhibitor and placebo (Kumar, 2022).

In November 2020, FDA expanded approval of baloxavir to include post exposure prophylaxis of influenza for persons aged ≥12 years within 48 hours of contact with an individual with influenza, based on the findings of a clinical trial among household contacts of index patient with influenza (Ikematsu, 2020). In this study, baloxavir post-exposure prophylaxis (PEP) of influenza in household members (19% were younger than 12 years; 73% received baloxavir within 24 hours of onset of symptoms in the index household case who received antiviral treatment) significantly reduced the risk of laboratory confirmed by 86% among those who received baloxavir PEP than among those who received placebo (1.9% [7 of 374] vs. 13.6% [51 of 375]; adjusted risk ratio, 0.14; 95% confidence interval [CI], 0.06 to 0.30; P<0.001).

In August 2022, FDA expanded approval of baloxavir for post-exposure prophylaxis of influenza in persons aged 5 years and older within 48 hours of contact with an individual with influenza package insert XOFLUZA [963 KB, 22 pages].

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