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A groundbreaking study published in The New England Journal of Medicine indicates that a single oral dose of baloxavir marboxil (baloxavir) can significantly hinder the transmission of influenza among household members. This advancement represents a critical step forward in the management of influenza. Conducted by a collaborative team from the LKS Faculty of Medicine and the University of Hong Kong (HKUMed), the CENTERSTONE trial offers the first substantial evidence that an antiviral treatment can effectively limit the spread of influenza to those living in close proximity.
The phase 3b, double-blind, randomized, placebo-controlled trial included 1,457 index patients confirmed to have influenza and 2,681 household contacts across 15 countries from 2019 to 2024. Participants, aged between 5 and 64, were administered either baloxavir or a placebo within 48 hours of exhibiting symptoms. The primary goal was to determine the occurrence of laboratory-confirmed influenza transmission to household contacts by day 5.
Key Findings:
- Treatment with baloxavir decreased the likelihood of unvaccinated household members contracting the virus by 32%.
- Symptomatic cases of influenza were lower in the baloxavir group (5.8%) compared to the placebo group (7.6%), although this difference was not statistically significant (P=0.16).
- Baloxavir expedited the reduction of viral titers, achieving a mean decrease of 2.22 log₁₀ TCID₅₀/mL by day 3 in comparison to 1.85 log₁₀ TCID₅₀/mL with the placebo.
- Drug-resistant viruses were identified in 7.2% of patients treated with baloxavir; however, these were not found in household contacts, indicating a minimal risk of spread.
- No new safety issues were noted, with adverse events reported in 4.6% of patients receiving baloxavir versus 7.0% in the placebo group.
Professor Benjamin Cowling, a co-author of the study and Chair Professor of Epidemiology at HKUMed, stated, “These findings emphasize baloxavir’s potential not only to treat influenza but also to mitigate its transmission within communities. This dual action could significantly change our approach to managing seasonal influenza and preparing for future pandemics.”
The research highlights the important complementary function of antiviral medications in conjunction with vaccination efforts, particularly for populations that are unvaccinated or during pandemic scenarios when vaccines may not be readily accessible.
Source
www.sciencedaily.com