Baloxavir marboxil as a new specific anti-influenza drug

Abstract

Introduction. Baloxavir marboxil is the first antiviral drug with a unique single dose, registered in Russia in September 2020 under the trade name Xoflusa for the treatment of infection caused by influenza A and B viruses. The article presents an overview of studies on the anti-influenza activity of Baloxavir marboxil by foreign colleagues. The data of scientific articles by different authors were analyzed and in vitro results and clinical data were taken into account, which can help in making recommendations for the use of the drug for the treatment and post-exposure prophylaxis of influenza.
 Review. Baloxavir marboxil acts as a selective low molecular weight inhibitor of an enzyme specific to the influenza virus in the viral RNA polymerase complex and is effective against strains resistant to oseltamivir. Combined phenotypic analysis and analysis based on the sequence in the protein of PA polymerase showed that the frequency of viruses showing reduced susceptibility to the drug remains low. Numerous studies have demonstrated the safe profile and productivity of influenza treatment in patients of various population groups (without risk factors and high-risk patients).
 Conclusions. Baloxavir marboxil stops the replication of the influenza virus in the early stages of the process, which leads to the termination of its release during the first day, and on the second day significantly relieves the patient's condition. Monitoring of the antiviral activity of the drug, especially in groups of children under the age of 12 and people with weakened immunity, should be closely monitored in order to develop clinical recommendations to prevent the formation of substitutions I38 (I38T/F/M/S/L/V) in the PA of influenza A and B viruses that reduce their sensitivity to the drug.