Baloxavir is an antiviral drug that was FDA approved in 2018 for the treatment of influenza. It works by inhibiting an enzyme that influenza needs to replicate its DNA. When taken early, it can shorten the course of influenza by a day.
But can it also prevent influenza?
Researchers working for Shionogi, the manufacturer of baloxavir, set up a clinical trial in Japan to test this question. During the 2018-2019 flu season, they identified patients with influenza when they went to see their primary care doctor.
The researchers offered the household contacts of these patients either baloxavir or a placebo. Ten days later, the researchers tested the household contacts for influenza RNA (clinical influenza) using RT-PCR.
1.9% of household contacts who took the active treatment had clinical influenza whereas 13.6% of household contacts who took the placebo had clinical influenza. This is a successful demonstration that Baloxavir is effective at preventing influenza and as such was recently FDA approved for this use.
The authors of this study were not able to rule out whether this chemical can contribute to the rise of drug-resistant influenza. Further research is needed on this topic.
Ikematsu H, Hayden FG, Kawaguchi K, et al. Baloxavir marboxil for prophylaxis against influenza in household contacts. N Engl J Med. 2020 Jul 23; 383(4):309-320. doi 10.1056/NEJMoa1915341. PMID: 32640124.