Comparative study of Baloxavir Marboxil and Oseltamivir for treating influenza in children aged 12–18 years

doi:10.5246/jcps.2025.08.057

Abstract

Abstract:

This study analyzed case and prescription data of children aged 12 to 18 years diagnosed with influenza A from the outpatient and emergency departments at the Women and Children’s Hospital of Ningbo University during the influenza epidemic period between February and April 2023. Patients were categorized into two groups based on their medication: the Baloxavir Marboxil group (196 cases) and the Oseltamivir group (126 cases). SPSS Statistics 24.0 software was utilized to compare variables between the two groups, including age, sex, weight, first visit department, number of visits, average prescription cost per patient, drug varieties used, hospitalization rate, and the combined medication usage, to evaluate the relative advantages and disadvantages of the two treatments. The results indicated that the number of visits in the Baloxavir Marboxil group was significantly lower than in the Oseltamivir group, whereas the average prescription cost per patient was higher (P < 0.05). There were no significant differences between the two groups regarding age, sex, weight, first visit department, number of drug types used, hospitalization rate, or combined medication usage (P > 0.05). When comparing the use of single-class combined drugs, only the quantity of antiviral drugs differed significantly (P < 0.05). The Oseltamivir group required more adjuvant treatment with both Chinese and Western antiviral medications. The distribution of the number of combined drug types was concentrated around three and two types in both groups (Baloxavir Marboxil group: 41.34% and 39.66%; Oseltamivir group: 44.54% and 36.97%). This study highlighted that the new drug, Baloxavir Marboxil, offered certain therapeutic benefits over Oseltamivir in treating influenza among children aged 12 to 18 years, including advantages in single-dose administration, oral compliance, and specific treatment outcomes. The higher unit cost associated with Baloxavir Marboxil might be a factor for further consideration. These findings provided a new reference point for the clinical selection of anti-influenza medications.

Key words: Baloxavir Marboxil, Oseltamivir, 12–18 years old, Influenza children

Supporting:

Yingyan Yan, Longhui Shen, Peizhi Mao, Zhuoer Zhu, Chaohui Ye, Yi Chen. Comparative study of Baloxavir Marboxil and Oseltamivir for treating influenza in children aged 12–18 years[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(8): 767-774.

Figures/Tables 4

Table 1. Comparison of general information on Baloxavir Marboxil and Oseltamivir groups.

Table 2. Comparison of combination use of Baloxavir Marboxil and Oseltamivir in the two groups.

Table 3. Comparison of combined single-class drug use between the Baloxavir Marboxil and Oseltamivir groups.

Table 4. The number of drug combinations between the Baloxavir Marboxil and Oseltamivir groups.

References 17

[1]	Tejus, A.; Mathur, A.G.; Pradhan, S.; Malik, S.; Salmani, M.F. Drug update - baloxavir marboxil: latest entrant into the arena of pharmacotherapy of influenza. Med. J. Armed Forces Ind. 2022, 78, 125–130.
[2]	Yu, Q.; Zhou, H.; Zhang, T.; Li, C.L.; Wu, Y.H. Analysis of clinical characteristics and risk factors of influenza-related deaths in children. Chin. J. Pediatr. 2020, 58, 910–916.
[3]	China National Clinical Research Center for Respiratory Diseases Group of Respirology, Chinese Pediatric Society Chinese Medical Association. Expert consensus on diagnosis and treatment of influenza in children (2020 Edition). Chin. J. Appl. Clin. Pediatr. 2020, 35, 1281–1288.
[4]	Wu, Y.; Chen, Q.T.; Chen, F.Z.; Wu, C.L.; Liu, W.; Li, X.J.; Chen, Z.B. Rapid health technology assessment of baloxavir marboxil in the treatment of influenza. China Pharm. 2023, 34, 2402–2408.
[5]	Takeuchi, M.; Kawakami, K. Association of baloxavir marboxil prescription with subsequent medical resource utilization among school-aged children with influenza. Pharmacoepidemiol. Drug Saf. 2021, 30, 779–786.
[6]	Świerczyńska, M.; Mirowska-Guzel, D.M.; Pindelska, E. Antiviral drugs in influenza. Int. J. Environ. Res. Public. Health. 2022, 19, 3018.
[7]	Locke, S.C.; Splawn, L.M.; Cho, J.C. Baloxavir marboxil: a novel cap-dependent endonuclease (CEN) inhibitor for the treatment of acute uncomplicated influenza. Drugs Today. (Barc). 2019, 55, 359–366.
[8]	Jin, Y.R.; Li, A.X.; Kang, J.X. Insights from investigating the interactions of natural product inhibitors with neuraminidase of the 2009 H1N1 influenza virus. J. Chin. Pharm. Sci. 2020, 29, 390–397.
[9]	Centers for Disease Control and Prevention (CDC). Influenza antiviral medications: summary for clinicians. Dec 27, 2018. https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm. Accessed Mar 15, 2019.
[10]	Uyeki, T.M.; Bernstein, H.H.; Bradley, J.S.; Englund, J.A.; File, T.M.; Fry, A.M.; Gravenstein, S.; Hayden, F.G.; Harper, S.A.; Hirshon, J.M.; Ison, M.G.; Johnston, B.L.; Knight, S.L.; McGeer, A.; Riley, L.E.; Wolfe, C.R.; Alexander, P.E.; Pavia, A.T. Clinical practice guidelines by the infectious diseases society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenzaa. Clin. Infect. Dis. 2019, 68, e1–e47.
[11]	Shirley, M. Baloxavir marboxil: a review in acute uncomplicated influenza. Drugs. 2020, 80, 1109–1118.
[12]	Norikoshi, Y.; Ikeda, T.; Sasahara, K.; Hamada, M.; Torigoe, E.; Nagae, M.; Tashiro, T.; Horio, F.; Saruwatari, J.; Uchida, Y.; Anraku, M. A comparison of the frequency of prescription and pharmacy revisits between baloxavir marboxil and neuraminidase inhibitors in influenza-infected pediatric patients during the 2019-2020 influenza season. Biol. Pharm. Bull. 2020, 43, 1960–1965.
[13]	Taieb, V.; Ikeoka, H.; Ma, F.F.; Borkowska, K.; Aballéa, S.; Tone, K.; Hirotsu, N. A network meta-analysis of the efficacy and safety of baloxavir marboxil versus neuraminidase inhibitors for the treatment of influenza in otherwise healthy patients. Curr. Med. Res. Opin. 2019, 35, 1355–1364.
[14]	Kikuchi, T.; Watanabe, A. Baloxavir heralds a new era in influenza virus biology. Respir. Investig. 2019, 57, 1–2.
[15]	Kawaguchi, N.; Koshimichi, H.; Ishibashi, T.; Wajima, T. Evaluation of drug-drug interaction potential between baloxavir marboxil and oseltamivir in healthy subjects. Clin. Drug Investig. 2018, 38, 1053–1060.
[16]	Ma, L.N.; Miao, M.S. Analysis on the rule of Chinese traditional medicine in treating influenza based on data mining. Chin. J. Mod. Appl. Pharm. 2020, 37, 837–841.
[17]	Huang, G.L.; He, W.J.; Zhao, X.J.; Zhao, Y.H.; Cui, W.Y.; Liu, X.J. Clinical research progress of new Cap-dependent endonuclease inhibitor baloxavir marboxil in treatment of influenza. Chin. J. New. Drugs Clin. Rem. 2022, 41, 641–645.