What you should know about the new flu drug, Xofluza

The Morning Call - - HEALTH - By Marie McCul­loug

The first new in­fluenza drug in 20 years was ap­proved in Oc­to­ber, and maker Ge­nen­tech says Xofluza be­gan reach­ing phar­ma­cies re­cently — good tim­ing for flu sea­son.

With a sin­gle pill, Xofluza can shorten the fevers, chills, sore throat, and other symp­toms that make a bout of the flu so mis­er­able.

That’s not to sug­gest Xofluza is mag­i­cal. It has lim­i­ta­tions, just like Tam­i­flu, the well-known an­tivi­ral that has been around for 20 years. Ex­perts still urge that you get the flu vac­cine to re­duce your chance of in­fec­tion.

But as U.S. Food and Drug Ad­min­is­tra­tion Com­mis­sioner Scott Got­tlieb said in an­nounc­ing its ap­proval, Xofluza “pro­vides an im­por­tant, ad­di­tional treat­ment op­tion.”

Here are things to con­sider about that op­tion — and the flu.

A mu­tat­ing tar­get

Last flu sea­son was the worst in decades, sick­en­ing 49 mil­lion peo­ple and killing 79,000. The dom­i­nant virus strain mu­tated and un­der­cut the ef­fec­tive­ness of the vac­cine, which is made each year to try to match cir­cu­lat­ing strains. On top of that, far fewer peo­ple got flu shots.

It isn’t yet clear how bad this sea­son will be, but as of late Novem­ber, fed­eral sur­veil­lance showed lit­tle or no flu ac­tiv­ity in most states.

The win­dow of op­por­tu­nity

Xofluza (balox­avir mar­boxil) works by pre­vent­ing the virus from copy­ing it­self, while Tam­i­flu (os­eltamivir phos­phate) and two sim­i­lar drugs keep the virus from spread­ing within the body. Ei­ther way, an­tivi­rals should be given within 48 hours of the first symp­toms to be ef­fec­tive.

Eb­bing Laut­en­bach, chief of in­fec­tious dis­eases at the Univer­sity of Penn­syl­va­nia, said the flu usu­ally hits hard and sud­denly — un­like, say, a cold.

“But it still re­quires a pa­tient to feel lousy and then fairly quickly con­tact their provider,” he said. “If you’re out­side the 48-hour win­dow, there’s not much to be gained” from an an­tivi­ral.

Suf­fer­ing less

Flu symp­toms typ­i­cally last from five to seven days. In the two clin­i­cal tri­als that led to ap­proval, Xofluza pro­vided re­lief more quickly than a placebo — by 26 hours.

Xofluza and Tam­i­flu were sim­i­lar in short­en­ing suf­fer­ing. As for side ef­fects, Xofluza had no more than a placebo, while Tam­i­flu may some­times cause nau­sea and vom­it­ing.

Sim­pler to use

Xofluza is a sin­gle dose, un­like Tam­i­flu, which is taken twice a day for five days.

In the­ory, Xofluza could re­duce the prob­lem of dru­gre­sis­tant viruses emerg­ing when pa­tients don’t fin­ish their an­tivi­ral pre­scrip­tion. But stud­ies of Xofluza have shown that the virus may de­velop re­sis­tance af­ter just one dose.

Not for ev­ery­one

Tam­i­flu is rec­om­mended for peo­ple at high risk of flu com­pli­ca­tions such as pneu­mo­nia, in­clud­ing chil­dren and older adults with chronic ill­nesses. Xofluza, in con­trast, is cur­rently ap­proved for peo­ple 12 and older.

Ge­nen­tech con­tin­ues to study the pill with an eye to­ward ex­panded ap­proval. It has al­ready been shown to shorten the flu in peo­ple at high risk of com­pli­ca­tions.

Cost

Xofluza costs $150, but Ge­nen­tech of­fers coupons to cut the out-of-pocket cost for in­sured and unin­sured pa­tients.

Tam­i­flu, which is made by Roche, the par­ent com­pany of Ge­nen­tech, also costs about $150. But generic os­eltamivir is avail­able for less than $50, ac­cord­ing to GoodRX.

GETTY

Xofluza pre­vents the flu virus from copy­ing it­self, un­like other drugs that keep the virus from spread­ing.

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