JAMA Intern Med
Baloxavir outperforms other antivirals in treating nonsevere influenza
Study design: This systematic review and meta-analysis aimed to compare the effects of antiviral drugs for treating nonsevere influenza. Randomized trials comparing direct-acting influenza antiviral drugs to placebo, standard care, or another antiviral drug for treating nonsevere influenza were selected.
Results: Out of 73 trials with 34,332 participants, all antiviral drugs showed little to no effect on mortality for both low- and high-risk patients (all high certainty). For hospital admissions, these drugs had minimal impact on low-risk patients (high certainty), while oseltamivir had little effect (high certainty) and baloxavir may have reduced risk in high-risk patients (low certainty). Baloxavir likely reduced symptom duration (moderate certainty), umifenovir* may have reduced it (low certainty), and oseltamivir probably had no significant effect (moderate certainty). Baloxavir had few adverse events (high certainty), whereas oseltamivir likely increased them (moderate certainty).
Clinical impact: Baloxavir likely reduces hospital admission risk for high-risk patients and may shorten symptom duration without increasing adverse events in nonsevere influenza. Other antiviral drugs likely have minimal or uncertain effects on important patient outcomes.
*Umifenovir is not approved in the U.S.
Source:
Gao Y, et al. (2025, January 13). JAMA Intern Med. Antiviral Medications for Treatment of Nonsevere Influenza: A Systematic Review and Network Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/39804622/