Early combination treatment with baloxavir and peramivir for hospitalized adults with influenza A in Yokohama, Japan

• Published in: European journal of clinical microbiology & infectious diseases Vol. 39; no. 9; pp. 1637 - 1640
• Main Authors: Yoshimura, Yukihiro, Sasaki, Hiroaki, Horiuchi, Hiroshi, Miyata, Nobuyuki, Kawakami, Chiharu, Usuku, Shuzo, Tachikawa, Natsuo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2020; Springer Nature B.V
• Subjects: Acids, Carbocyclic - administration & dosage; Acids, Carbocyclic - pharmacology; Acids, Carbocyclic - therapeutic use; Administration, Oral; Adults; Aged, 80 and over; Antiviral Agents - administration & dosage; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Antiviral drugs; Biomedical and Life Sciences; Biomedicine; Dibenzothiepins - administration & dosage; Dibenzothiepins - pharmacology; Dibenzothiepins - therapeutic use; Drug Resistance, Viral; Drug Therapy, Combination; Female; Guanidines - administration & dosage; Guanidines - pharmacology; Guanidines - therapeutic use; Hospitalization; Humans; Influenza; Influenza A; Influenza A virus - drug effects; Influenza A virus - isolation & purification; Influenza, Human - drug therapy; Influenza, Human - mortality; Internal Medicine; Japan; Male; Medical Microbiology; Morpholines - administration & dosage; Morpholines - pharmacology; Morpholines - therapeutic use; Mortality; Mutation; Original Article; Pyridones - administration & dosage; Pyridones - pharmacology; Pyridones - therapeutic use; Retrospective Studies; Sequence analysis; Statistical analysis; Triazines - administration & dosage; Triazines - pharmacology; Triazines - therapeutic use; Japan; Peramivir; Influenza; Combination; Baloxavir
• DOI: 10.1007/s10096-020-03888-7
• ISSN: 0934-9723; 1435-4373

Baloxavir marboxil is a new anti-influenza drug, but data on the clinical efficacy of a combination treatment of baloxavir and peramivir is scarce. We conducted a single-center retrospective analysis comparing the mortality of a combination of baloxavir and peramivir (B & P, n  = 10) and peramivir without baloxavir (P-mono, n  = 132) in hospitalized adults with influenza A between 2011 and 2019 in Yokohama City, Japan. Sequencing analysis was conducted in the B & P group to check the I38 mutation in polymerase acidic protein which is associated with baloxavir resistance. The 30-day mortality rates were 0 (0%) in the B & P group and 6 (4.5%) in the P-mono group, respectively, which was not statistically significant. The I38 mutation was not detected before and after the combination treatment. A combination treatment of baloxavir and peramivir might be more effective than peramivir without baloxavir and prevent the emergence of baloxavir resistance in hospitalized adults with influenza A.