tetano
Editor, Senior Moderator
Clin Infect Dis
. 2020 Dec 23;ciaa1870.
doi: 10.1093/cid/ciaa1870. Online ahead of print.
Comparison of Hospitalization Incidence in Influenza Outpatients Treated With Baloxavir Marboxil or Neuraminidase Inhibitors: A Health Insurance Claims Database Study
Takuji Komeda[SUP] 1 [/SUP], Takahiro Takazono[SUP] 2 3 [/SUP], Naoki Hosogaya[SUP] 3 [/SUP], Taiga Miyazaki[SUP] 2 [/SUP], Eriko Ogura[SUP] 4 [/SUP], Shinpei Iwata[SUP] 1 [/SUP], Hideyuki Miyauchi[SUP] 1 [/SUP], Keiichi Honda[SUP] 1 [/SUP], Masakazu Fujiwara[SUP] 4 [/SUP], Yoshikazu Ajisawa[SUP] 4 [/SUP], Hideaki Watanabe[SUP] 4 [/SUP], Yoshitake Kitanishi[SUP] 4 [/SUP], Kanae Hara[SUP] 4 [/SUP], Hiroshi Mukae[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Baloxavir marboxil (baloxavir) is a single-dose, oral anti-influenza drug with a novel mechanism of action. We compared the incidence of hospitalization in patients treated with baloxavir versus neuraminidase inhibitors.
Methods: This was a retrospective observational cohort study using real-world patient data extracted from a Japanese health insurance claims database. The enrollment period was October 1, 2018 to April 17, 2019. On day 1, eligible patients (N = 339 007) received baloxavir, oseltamivir, zanamivir, or laninamivir. Baseline characteristics were standardized using the inverse probability of treatment weighting method. Primary end point was the incidence of hospitalization (days 2-14). Secondary end points included antibacterial use, secondary pneumonia, and additional anti-influenza drug use.
Results: Compared with the baloxavir group, the incidence of hospitalization was greater in the oseltamivir group (risk ratio [RR] and 95% confidence interval [CI], 1.41 [1.00-2.00]; risk difference [RD] and 95% CI, 0.06 [0.01-0.12]) and zanamivir group (RR, 1.85 [1.23-2.78]; RD, 0.11 [0.02-0.20]). Oseltamivir-treated patients were less likely to require antibacterials than baloxavir-treated patients (RR, 0.87 [0.82-0.91]). However, oseltamivir-treated patients were more likely to be hospitalized with antibacterials (RR, 1.70 [1.21-2.38]) or antibacterial injection (RR, 1.67 [1.17-2.38]) than baloxavir-treated patients (post hoc analysis). Compared with baloxavir-treated patients, additional anti-influenza drug use was greater in oseltamivir-, zanamivir-, and laninamivir-treated patients (RR, 1.51 [1.05-2.18], 2.84 [2.04-3.96], and 1.68 [1.35-2.10], respectively).
Conclusions: Baloxavir is an efficacious anti-influenza treatment that may reduce hospitalization compared with oseltamivir and zanamivir.
Keywords: Japan; baloxavir; hospitalization; human influenza; neuraminidase inhibitor.
. 2020 Dec 23;ciaa1870.
doi: 10.1093/cid/ciaa1870. Online ahead of print.
Comparison of Hospitalization Incidence in Influenza Outpatients Treated With Baloxavir Marboxil or Neuraminidase Inhibitors: A Health Insurance Claims Database Study
Takuji Komeda[SUP] 1 [/SUP], Takahiro Takazono[SUP] 2 3 [/SUP], Naoki Hosogaya[SUP] 3 [/SUP], Taiga Miyazaki[SUP] 2 [/SUP], Eriko Ogura[SUP] 4 [/SUP], Shinpei Iwata[SUP] 1 [/SUP], Hideyuki Miyauchi[SUP] 1 [/SUP], Keiichi Honda[SUP] 1 [/SUP], Masakazu Fujiwara[SUP] 4 [/SUP], Yoshikazu Ajisawa[SUP] 4 [/SUP], Hideaki Watanabe[SUP] 4 [/SUP], Yoshitake Kitanishi[SUP] 4 [/SUP], Kanae Hara[SUP] 4 [/SUP], Hiroshi Mukae[SUP] 2 [/SUP]
Affiliations
- PMID: 33354728
- DOI: 10.1093/cid/ciaa1870
Abstract
Background: Baloxavir marboxil (baloxavir) is a single-dose, oral anti-influenza drug with a novel mechanism of action. We compared the incidence of hospitalization in patients treated with baloxavir versus neuraminidase inhibitors.
Methods: This was a retrospective observational cohort study using real-world patient data extracted from a Japanese health insurance claims database. The enrollment period was October 1, 2018 to April 17, 2019. On day 1, eligible patients (N = 339 007) received baloxavir, oseltamivir, zanamivir, or laninamivir. Baseline characteristics were standardized using the inverse probability of treatment weighting method. Primary end point was the incidence of hospitalization (days 2-14). Secondary end points included antibacterial use, secondary pneumonia, and additional anti-influenza drug use.
Results: Compared with the baloxavir group, the incidence of hospitalization was greater in the oseltamivir group (risk ratio [RR] and 95% confidence interval [CI], 1.41 [1.00-2.00]; risk difference [RD] and 95% CI, 0.06 [0.01-0.12]) and zanamivir group (RR, 1.85 [1.23-2.78]; RD, 0.11 [0.02-0.20]). Oseltamivir-treated patients were less likely to require antibacterials than baloxavir-treated patients (RR, 0.87 [0.82-0.91]). However, oseltamivir-treated patients were more likely to be hospitalized with antibacterials (RR, 1.70 [1.21-2.38]) or antibacterial injection (RR, 1.67 [1.17-2.38]) than baloxavir-treated patients (post hoc analysis). Compared with baloxavir-treated patients, additional anti-influenza drug use was greater in oseltamivir-, zanamivir-, and laninamivir-treated patients (RR, 1.51 [1.05-2.18], 2.84 [2.04-3.96], and 1.68 [1.35-2.10], respectively).
Conclusions: Baloxavir is an efficacious anti-influenza treatment that may reduce hospitalization compared with oseltamivir and zanamivir.
Keywords: Japan; baloxavir; hospitalization; human influenza; neuraminidase inhibitor.