Efficacy of Baloxavir Treatment in Preventing Transmission of Influenza
Abstract
- The CENTERSTONE phase 3b, double-blind, placebo-controlled trial evaluated whether a single oral dose of baloxavir marboxil a cap-dependent endonuclease inhibitor could reduce household transmission of influenza. The study enrolled 1457 influenza-positive index patients aged 5–64 years and 2681 household contacts across 15 countries over five influenza seasons (2019–2024). Compared to placebo, baloxavir significantly reduced transmission by day 5 (adjusted incidence: 9.5% vs. 13.4%; adjusted odds ratio: 0.68; P=0.01), resulting in a 29% relative risk reduction. However, the reduction in symptomatic transmission (5.8% vs. 7.6%) was not statistically significant (P=0.16). Viral titers declined more rapidly with baloxavir, and no resistant viruses were detected in household contacts despite emerging resistance in 7.2% of index patients. Safety profiles were comparable. The findings suggest that baloxavir not only shortens illness duration but may also serve as a public health intervention to reduce influenza spread particularly within households
Keywords:
baloxavir
influenza
antiviral therapy
household transmission
randomized trial
viral shedding
cap-dependent endonuclease inhibitor
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