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<p>Baloxavir marboxil (baloxavir) shows satisfactory efficacy and safety for treating influenza, particularly influenza A. However, real-world evidence for influenza B in Chinese populations is scarce. This study aimed to explore the efficacy and safety of baloxavir vs. oseltamivir in Chinese outpatients with influenza B. This real-world cohort study included 811 outpatients with influenza B between November 2023 and January 2024, comprising 394 patients in the baloxavir group and 417 patients in the oseltamivir group. Inverse probability of treatment weighting (IPTW) was applied to minimize potential confounding and achieve covariate balance. In both unweighted and IPTW-weighted cohorts, time to fever resolution was shorter in the baloxavir group (median: 24.0&#xa0;h) compared with the oseltamivir group (median: 48.0&#xa0;h) (both <i>P</i> &lt; 0.001). In both cohorts, the baloxavir group (median: 120.0&#xa0;h) had a shorter time to symptom resolution than the oseltamivir group (median: 168.0&#xa0;h) (both <i>P</i> &lt; 0.001). Due to residual imbalance, time from symptom onset to antiviral initiation was adjusted for in the multivariable Cox model. After adjustment, the baloxavir group remained associated with faster fever resolution and symptom resolution (all <i>P</i> &lt; 0.001). The incidence of any adverse events was lower in the baloxavir group than in the oseltamivir group (3.6% vs. 10.3%) (<i>P</i> &lt; 0.001). Headache was more frequent (1.3% vs. 0.0%), whereas nausea (0.0% vs. 6.7%) and vomiting (0.0% vs. 6.5%) were less frequent in the baloxavir group vs. the oseltamivir group (all <i>P</i> &lt; 0.05). Baloxavir achieves faster fever resolution and symptom resolution, with a better safety profile in Chinese outpatients with influenza B.</p>

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Efficacy and safety of baloxavir marboxil vs. oseltamivir in Chinese outpatients with influenza B: an IPTW-adjusted real-world cohort study

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • Zhixiang Gong,
  • Xiaonan Yu,
  • Qiaoli Han,
  • Ling Lu,
  • Yang Liu,
  • Bin Pei,
  • Zi Wang

摘要

Baloxavir marboxil (baloxavir) shows satisfactory efficacy and safety for treating influenza, particularly influenza A. However, real-world evidence for influenza B in Chinese populations is scarce. This study aimed to explore the efficacy and safety of baloxavir vs. oseltamivir in Chinese outpatients with influenza B. This real-world cohort study included 811 outpatients with influenza B between November 2023 and January 2024, comprising 394 patients in the baloxavir group and 417 patients in the oseltamivir group. Inverse probability of treatment weighting (IPTW) was applied to minimize potential confounding and achieve covariate balance. In both unweighted and IPTW-weighted cohorts, time to fever resolution was shorter in the baloxavir group (median: 24.0 h) compared with the oseltamivir group (median: 48.0 h) (both P < 0.001). In both cohorts, the baloxavir group (median: 120.0 h) had a shorter time to symptom resolution than the oseltamivir group (median: 168.0 h) (both P < 0.001). Due to residual imbalance, time from symptom onset to antiviral initiation was adjusted for in the multivariable Cox model. After adjustment, the baloxavir group remained associated with faster fever resolution and symptom resolution (all P < 0.001). The incidence of any adverse events was lower in the baloxavir group than in the oseltamivir group (3.6% vs. 10.3%) (P < 0.001). Headache was more frequent (1.3% vs. 0.0%), whereas nausea (0.0% vs. 6.7%) and vomiting (0.0% vs. 6.5%) were less frequent in the baloxavir group vs. the oseltamivir group (all P < 0.05). Baloxavir achieves faster fever resolution and symptom resolution, with a better safety profile in Chinese outpatients with influenza B.