Baloxavir Marboxil in Chinese Pediatric Patients Aged 1 to < 5 Years with Influenza: Safety and Clinical and Virologic Outcomes
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: INTRODUCTION: Baloxavir marboxil (baloxavir), a cap-dependent endonuclease inhibitor, has been proven safe and efficacious against influenza and approved for the treatment of influenza in children aged ≥ 5 years in China. There were limited data on baloxavir in Chinese pediatric patients aged 1 to < 5 years with influenza. This study aimed to evaluate the safety, clinical efficacy, and virologic outcomes of baloxavir for treating influenza in this younger age group. METHODS: In this single-arm, multicenter trial, patients received a single oral dose of baloxavir (2 mg/kg for participants weighing < 20 kg, or 40 mg for participants weighing ≥ 20 kg to < 80 kg). The primary endpoint was safety. Efficacy, virology, and palatability endpoints were also assessed. RESULTS: All 100 enrolled children completed the study and received baloxavir. Adverse events were reported in 29 (29.0%) children, most commonly bronchitis and diarrhea. No death or adverse events leading to discontinuation occurred. Eighty children were included in the clinical efficacy and virologic assessment. The median [95% confidence interval (CI)] time to resolution of influenza signs and symptoms was 150.17 (90.23, NE) h. The median duration of fever was 38.65 (95% CI 25.32, 42.35) h. Infectious virus titers rapidly declined by day 2 post-dose. The proportion of subjects with a positive viral titer was reduced to 8.7% at this timepoint. Of the 100 children enrolled, more than 70% of children rated baloxavir as favorable in the palatability test. CONCLUSION: A single, oral dose of baloxavir was well-tolerated in Chinese children aged 1 to < 5 years, with rapid influenza virus clearance and associated symptom alleviation, suggesting baloxavir was an important treatment option for Chinese pediatric patients with influenza. TRIAL REGISTRATION: The study was registered at the Chinese Clinical Trial Registry (ChiCTR) on March 14, 2025 (registration no. ChiCTR2500098911); Retrospectively registered.
Source: Infectious Diseases and Therapy
Institutions: Capital Medical University, Beijing Children’s Hospital, Tongji University, Nanjing Children's Hospital, Wenzhou Medical University, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Capital Institute of Pediatrics, Children's Hospital of Capital Institute of Pediatrics, Zhengzhou University, Zhengzhou Children's Hospital, Children's Hospital of Zhejiang University, Zhejiang University, Tongji Hospital, Huazhong University of Science and Technology
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $7,400
OpenAlex ID: W4415459224
