Recently released results of international drug trial exhibit potential for hindering avian flu transmission

A single administration of the antiviral baloxavir marboxil reduces the likelihood of passing the influenza virus to family members by approximately 30%, as per research published in the New England Journal of Medicine.

In the investigation, a Phase III global trial of baloxavir marboxil (marketed as Xofluza) spearheaded by University of Michigan epidemiologist Arnold Monto, revealed that the medication significantly diminished the viral shedding that infects those in close proximity.

Referred to as the CENTERSTONE trial, the research encompassed 1,457 influenza-positive patients aged 5-64 and 2,681 household connections. Participants were allocated either baloxavir or a placebo at random, while their contacts were monitored for influenza transmission.

“There has always been a query—could antivirals, known to shorten the duration of influenza when administered early, also hinder the spread of influenza?” Monto stated, who has long been a consultant on vaccines and respiratory infections for the Centers for Disease Control and Prevention and the Federal Drug Administration.

“For many years, we have utilized drugs to treat influenza, but it remained uncertain whether there was any reduction in transmission from infected individuals. It was also ambiguous whether this uncertainty stemmed from the lack of a study specifically intended to investigate transmission reduction or if transmission simply was not occurring.”

“Our research aimed to directly ascertain if this meant we could finally demonstrate that transmission could indeed be lowered, and we succeeded in doing so.”

Co-author Adam Lauring, head of the Division of Infectious Diseases at the U-M Medical School, mentioned that the results indicate significant possibilities for decreasing flu prevalence.

“This was a genuinely thrilling study to engage in,” remarked Lauring, who is a professor of internal medicine and microbiology and immunology. “It showcases how we might be able to employ an antiviral to benefit not only our patients but also their households and wider communities by preventing influenza transmission. It could revolutionize our approach to future influenza outbreaks.”

As other influenza antivirals necessitate a daily dosage for five days, and since baloxavir is administered as a single dose, this may lead to increased adoption of treatment “as it not only protects oneself from complications but also safeguards others,” noted Monto, professor emeritus of epidemiology and global public health at the U-M School of Public Health and co-director of the Michigan Center for Respiratory Virus and Research and Response.

“These results bolster the justification for treating influenza patients with this antiviral. It’s a twofold benefit: reducing the illness duration, which can also prevent complications that could lead to hospitalizations or fatalities, while simultaneously decreasing transmission.”

An antiviral that minimizes viral shedding also shows potential for combating the propagation of avian flu, as per Monto. Although it has not been assessed for avian influenza in either birds or domestic livestock, studies conducted in laboratories have indicated that baloxavir inhibits the replication of these types of influenza as well.

Alongside support from the trial backer and manufacturer Roche, the investigation also received funding from the Center for the Biomedical Advanced Research and Development Authority, which operates under the Department of Health and Human Services.