Baloxavir Marboxil with lower hepatic toxicity safer option to oseltamivir in influenza patients with liver diseases: Study

Oseltamivir was associated with 221 significantly specific AEs. Few notable examples include appendicolith (ROR 459.53), infantile acne (ROR 368.65), acute macular neuroretinopathy (ROR 294.92), proctitis (ROR 245.74) and senile purpura (ROR 154.02). The medical events (DMEs) linked to Oseltamivir included fulminant hepatitis (ROR 12.12, n=27), ventricular fibrillation (ROR 7.68, n=64) and toxic epidermal necrolysis (ROR 7.21, n=75). Baloxavir Marboxil expressed 34 specific AEs, including melaena (ROR 21.34, n=23), hemorrhagic cystitis (ROR 20.22, n=4), paralytic ileus (ROR 18.57, n=3), and hemorrhagic diathesis (ROR 16.86, n=3). DMEs related to Baloxavir Marboxil included rhabdomyolysis (ROR 15.50, n=26).

The study highlighted the need for careful monitoring of fulminant hepatitis during Oseltamivir treatment in patients with pre-existing liver conditions. The potential for Oseltamivir to induce abnormal behavior in adolescents, also warrants close observation. But, Baloxavir Marboxil emerges as a potential alternative for patients with liver issues due to its lower hepatic toxicity. The risk of rhabdomyolysis during Baloxavir Marboxil treatment points towards careful monitoring of relevant indicators in symptomatic patients. Overall, this comprehensive data will help equip clinicians with valuable insights to enhance the existing understanding of the safety profiles of these influenza treatments in real-world settings. 

Source:

Li, Y., Wang, X., Liao, Y., Zeng, Y., Lin, W., & Zhuang, W. (2024). Safety analysis of Oseltamivir and Baloxavir Marboxil after market approval: a pharmacovigilance study based on the FDA adverse event reporting system. In BMC Infectious Diseases (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12879-024-09339-4