tetano
Editor, Senior Moderator
Clin Infect Dis
. 2022 Feb 1;ciac068.
doi: 10.1093/cid/ciac068. Online ahead of print.
Comparison of intra-familial transmission of influenza virus from index patients treated with baloxavir marboxil or oseltamivir using an influenza transmission model and a health insurance claims database
Shogo Miyazawa[SUP] 1 [/SUP], Takahiro Takazono[SUP] 2 3 [/SUP], Naoki Hosogaya[SUP] 2 4 [/SUP], Kazuko Yamamoto[SUP] 2 5 [/SUP], Hideaki Watanabe[SUP] 6 [/SUP], Masakazu Fujiwara[SUP] 1 [/SUP], Satoki Fujita[SUP] 1 [/SUP], Hiroshi Mukae[SUP] 2 5 [/SUP]
Affiliations
Abstract
Background: Influenza affects approximately a billion people globally, including >10 million Japanese individuals every year. Baloxavir marboxil (baloxavir [BXM]; a selective cap-dependent endonuclease inhibitor) is approved for influenza treatment in Japan. We compared the incidence of intra-familial transmission of influenza between BXM and oseltamivir (OTV) treatments using a simulation model.
Methods: Using the JMDC claims database, we identified index case (ICs) as the first family member diagnosed with influenza during the 2018-2019 influenza season, and classified the families into BXM or OTV group per the drug dispensed to ICs. Using a novel influenza intra-familial infection model, we simulated the duration of influenza infection in ICs based on agent-specific virus shedding periods. Intra-familial infections were defined as non-IC family members infected during the agent-specific viral shedding period in ICs. The virus incubation periods in the non-IC family members were considered to exclude secondary infections from potentially external exposure. The primary endpoint was proportion of families with intra-familial infections. For between-group comparisons, we used a multivariate logistic regression model.
Results: The median proportion of families with intra-familial transmission was 9.57% and 19.35% in the BXM (N=84,672) and OTV (N=62,004) groups, respectively. The multivariate odds ratio of 1.73 (2.5th-97.5th percentiles, 1.68-1.77) indicated a substantially higher incidence of intra-familial infections in the OTV group versus the BXM group. Subgroup analyses by ICs' age category, virus type, and month of onset revealed similar trends favoring BXM.
Conclusion: BXM treatment of ICs may contribute to a greater reduction in intra-familial influenza transmission than OTV treatment.
Keywords: Japan; baloxavir marboxil; influenza virus; intra-familial infection; oseltamivir.
. 2022 Feb 1;ciac068.
doi: 10.1093/cid/ciac068. Online ahead of print.
Comparison of intra-familial transmission of influenza virus from index patients treated with baloxavir marboxil or oseltamivir using an influenza transmission model and a health insurance claims database
Shogo Miyazawa[SUP] 1 [/SUP], Takahiro Takazono[SUP] 2 3 [/SUP], Naoki Hosogaya[SUP] 2 4 [/SUP], Kazuko Yamamoto[SUP] 2 5 [/SUP], Hideaki Watanabe[SUP] 6 [/SUP], Masakazu Fujiwara[SUP] 1 [/SUP], Satoki Fujita[SUP] 1 [/SUP], Hiroshi Mukae[SUP] 2 5 [/SUP]
Affiliations
- PMID: 35100617
- DOI: 10.1093/cid/ciac068
Abstract
Background: Influenza affects approximately a billion people globally, including >10 million Japanese individuals every year. Baloxavir marboxil (baloxavir [BXM]; a selective cap-dependent endonuclease inhibitor) is approved for influenza treatment in Japan. We compared the incidence of intra-familial transmission of influenza between BXM and oseltamivir (OTV) treatments using a simulation model.
Methods: Using the JMDC claims database, we identified index case (ICs) as the first family member diagnosed with influenza during the 2018-2019 influenza season, and classified the families into BXM or OTV group per the drug dispensed to ICs. Using a novel influenza intra-familial infection model, we simulated the duration of influenza infection in ICs based on agent-specific virus shedding periods. Intra-familial infections were defined as non-IC family members infected during the agent-specific viral shedding period in ICs. The virus incubation periods in the non-IC family members were considered to exclude secondary infections from potentially external exposure. The primary endpoint was proportion of families with intra-familial infections. For between-group comparisons, we used a multivariate logistic regression model.
Results: The median proportion of families with intra-familial transmission was 9.57% and 19.35% in the BXM (N=84,672) and OTV (N=62,004) groups, respectively. The multivariate odds ratio of 1.73 (2.5th-97.5th percentiles, 1.68-1.77) indicated a substantially higher incidence of intra-familial infections in the OTV group versus the BXM group. Subgroup analyses by ICs' age category, virus type, and month of onset revealed similar trends favoring BXM.
Conclusion: BXM treatment of ICs may contribute to a greater reduction in intra-familial influenza transmission than OTV treatment.
Keywords: Japan; baloxavir marboxil; influenza virus; intra-familial infection; oseltamivir.