Xofluza (baloxavir marboxil, BMX) appears to be more effective than oseltamivir (OTV, Tamiflu) in lowering the secondary attack rate (SAR) of flu, according to a new study based on transmission dynamics in Japanese households. The study was published yesterday in Influenza and Other Respiratory Viruses.
Both flu antivirals are approved for use in the United States and Japan, and the study assessed secondary transmission rates among 185 index case-patients (116 treated with BXM and 69 treated with OTV) and 410 household contacts. Almost all index patients (97.8%) had influenza A infection.
More adherence for BMX
The secondary attack rate in household contacts of index cases treated with BXM and OTV was 10.8% and 18.5%, respectively. The authors calculated that the adjusted relative reduction in SAR was 41.8% (95% confidence interval, 1.0% to 65.7%).
In a subgroup of index patients 12 years and under, BMX performed better than OTV. This may because of adherence, the authors said, as BMX is a single dose versus twice daily dosing for 5 days for OTV.
The secondary influenza illness attack rate was lower in household contacts exposed to BXM-treated than OTV-treated index case.
"The secondary influenza illness attack rate was lower in household contacts exposed to BXM-treated than OTV-treated index case," the authors concluded. "The more rapid reduction in infectious virus titers associated with BXM compared to OTV treatment may explain BXM's greater reduction in secondary household transmission than observed with OTV."