BALOXAVIR: ANTI-INFLUENZA VIRUS AGENT VIA INHIBITION OF CAP-DEPENDENT ENDRONUCLEASE

Abstract

Influenza is an acute respiratory infection caused by a virus. Influenza A and influenza B are the two main types of influenza viruses that cause seasonal influenza epidemics each year. Influenza can also cause illness and can lead to death, especially in those at-risk patients with flu-related severe complications, e.g., the older adults aged 65 years and over, and patients with either chronic lung disease, diabetes mellitus, or immune deficiency. Early treatment of influenza can reduce the risk of severe complications. Currently, there are many limitations for influenza medication, such as oseltamivir - a neuraminidase inhibitors which inhibits the release of newly replicated influenza virus. Moverover, the lengthy treatment duration of five days, and common drug-related adverse event such as nausea and vomiting are also limitations for oseltamivir. Baloxavia has been approved by the US Food and Drug Administration (FDA) since October 2018. Baloxavir, a novel drug, is indicated for the treatment of acute uncomplicated influenza in patients aged 12 years and older whose symptom has occurred for not more than 48 hours. Baloxavir inhibits the cap-dependent endonuclease (CEN), which is required for viral gene transcription, and effectively inhibit viral replication while oseltamivir inhibits the neuraminidase enzyme. Consequently, baloxavir is superior to oseltamivir in a reduction in the number of viruses. Clinical studies assessing the effectiveness of the drug in the reduction of influenza A and B viral titer revealed that the time required to alleviate the symptoms and adverse effect are similar between baloxavir and oseltamivir. Baloxavir is oral-administered, and it can reduce the level of influenza A and B on the first day. Baloxavir has a long half-life and used as a single-dose treatment. Consequently, baloxavir is an alternative option to current therapy for acute uncomplicated influenza.