Feb 12, 2021
Contributor: Rachael Duncan, PharmD BCPS
Educational Pearls:
- According to the Department of Public Health
and Environment who puts out a weekly report on the influenza virus
in Colorado, there appears to be less influenza in Colorado than
previous years
- A milder influenza outbreak is likely due to
mask wearing and social distancing practices
- There have only been 22 hospitalizations for
influenza in Colorado since the start of the flu season back in
September and 0 outbreaks in long-term care
facilities
- Xofluza (baloxavir marboxil) is an
antiviral PA endonuclease inhibitor
and was approved by the FDA
in 2018 for uncomplicated influenza in patients 12 years and older
that have been symptomatic for less than 48 hours
- Patient’s getting Xofluza must be otherwise
healthy or at risk of developing influenza-related
complications
- Due to limited data, Xofluza would not be a
good option for those that are inpatient or critically ill and is
best utilized for patients who are being seen in the emergency
department and will be sent home
- Currently Xofluza is not approved for
complicated patients, pregnant patients or those that are
breast-feeding which limits its use
- When compared with Tamiflu in phase 3 studies,
Xofluza was superior to placebo and similar to Tamiflu in
shortening the duration of illness
- Xofluza is a single dose that is weight based
and appears to be very well tolerated with some adverse effects
including headache, nausea and diarrhea
- Xofluza showed a quicker recovery compared to
Tamiflu by 8 hours which could be related to its one-time
dosing
- Cost is a limiting factor for the use of
Xofluza. Tamiflu costs around $25 where as Xofluza (only available
as brand name currently) is $156 at the cheapest
- Pharmacists are still encouraging everyone to
get their influenza vaccines despite less influenza cases this
year
References:
Cdphe.colorado.gov.
2021. Influenza
(flu) | Department of Public Health &
Environment. [online]
Available at: <https://cdphe.colorado.gov/influenza>
[Accessed 11 February 2021].
Ison, M., Portsmouth, S.,
Yoshida, Y., Shishido, T., Mitchener, M., Tsuchiya, K., Uehara, T.
and Hayden, F., 2020. Early treatment with baloxavir marboxil in
high-risk adolescent and adult outpatients with uncomplicated
influenza (CAPSTONE-2): a randomised, placebo-controlled, phase 3
trial. The Lancet
Infectious Diseases,
20(10), pp.1204-1214.
Hayden, F., Sugaya, N., Hirotsu,
N., Lee, N., de Jong, M., Hurt, A., Ishida, T., Sekino, H., Yamada,
K., Portsmouth, S., Kawaguchi, K., Shishido, T., Arai, M.,
Tsuchiya, K., Uehara, T. and Watanabe, A., 2018. Baloxavir Marboxil
for Uncomplicated Influenza in Adults and
Adolescents. New
England Journal of Medicine, 379(10), pp.913-923.
Summarized by Emily Mack
OMSIII
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