In a new study, researchers systematically evaluated and meta-analyzed the effectiveness of multiple antiviral drugs for the treatment of non-severe influenza. The findings suggest that baloxavir may be a secret weapon for high-risk patients, as it not only shortens symptom duration, but may also reduce the risk of hospitalization and does not increase the risk of adverse events.
The findings were published online Jan. 13, 2025, in the journal JAMA Internal Medicine in a paper titled “Antiviral Medications for Treatment of Nonsevere Influenza: A Systematic Review and Network Meta-Analysis”.
Influenza is a viral respiratory disease that affects millions of people each year, with serious complications that can have fatal consequences. In response to this threat, scientists have developed different antiviral drugs that each have unique abilities to combat the influenza virus:
Neuraminidase inhibitors, such as oseltamivir and zanamivir , relieve symptoms by stopping the virus from spreading from cell to cell.
Endonuclease inhibitors, such as baloxavir, specifically attack the ability of the virus to replicate its genetic material.
Standout “Rising Star” - Baloxavir
In this battle against the flu, baloxavir is notable because it outperforms other antiviral drugs in some ways. According to this meta-analysis, baloxavir may shorten the duration of symptoms by about a day (1.02 days), which for high-risk patients not only means a faster return to health, but may also reduce the risk of hospitalization. Furthermore, the use of baloxavir does not increase the incidence of adverse events, which is good news for people who are concerned about side effects.
Specifically, to find the most effective treatment, the researchers collected data from 73 randomized clinical trials involving more than 34,000 participants from databases such as MEDLINE, Embase, and CENTRAL. They evaluated outcomes such as mortality, hospitalization, symptom relief, and adverse events, and assessed the certainty of the evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method. This systematic approach assesses the quality of evidence based on factors such as risk of bias, consistency of results, directness of evidence, and accuracy of estimates. This framework helps to determine the strength of the findings and their reliability for clinical decision-making.
Studies have shown that baloxavir has potential benefits in reducing symptom duration and reducing the risk of hospitalization in high-risk patients, although the level of certainty of this finding varies. For both low- and high-risk patients, baloxavir had little or no effect on mortality, an important finding. In addition, although baloxavir was associated with an approximately 10% risk of emergence of resistance, it caused fewer adverse events compared with placebo.
In contrast, oseltamivir had little effect on mortality and hospitalization rates, but it did reduce the duration of symptoms by an average of 0.75 days. However, the use of oseltamivir may increase the risk of adverse events. As for other antivirals, such as zanamivir, laninamivir, and abidol (umifenovir), their effects are inconsistent or uncertain, and the quality of the evidence ranges from moderate to very low.
Paths of discovery for the future
Although this study provides valuable information, it also points to some gaps that need to be filled by future research. In particular, more patient-specific outcome data are needed on intensive care unit admissions, length of hospitalization, and antiviral drug resistance. As a result, scientists will continue to work hard to find more answers about how to better protect us from influenza.
Post comments