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    Clinical Trial Results:
    A Multicenter, Randomized, Double-Blind, Active (Oseltamivir)-Controlled Study to Assess the Safety, Pharmacokinetics, and Efficacy of Baloxavir Marboxil in Otherwise Healthy Pediatric Patients 1 to <12 Years of Age With Influenza-Like Symptoms

    Summary
    EudraCT number
    2018-002169-21
    Trial protocol
    ES   PL  
    Global end of trial date
    03 Apr 2019

    Results information
    Results version number
    v2(current)
    This version publication date
    12 Mar 2020
    First version publication date
    12 Oct 2019
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    CP40563
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03629184
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
    Scientific contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-002440-PIP01-18
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    09 Jul 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    03 Apr 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Apr 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To compare the safety of a single dose of baloxavir marboxil with 5 days of oseltamivir administered twice daily.
    Protection of trial subjects
    All study subjects were required to read and sign an Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    20 Nov 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Costa Rica: 2
    Country: Number of subjects enrolled
    Spain: 3
    Country: Number of subjects enrolled
    Mexico: 1
    Country: Number of subjects enrolled
    Poland: 5
    Country: Number of subjects enrolled
    Russian Federation: 1
    Country: Number of subjects enrolled
    United States: 161
    Worldwide total number of subjects
    173
    EEA total number of subjects
    8
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    16
    Children (2-11 years)
    157
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    173 participants were enrolled and dosed in this study.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Baloxavir Marboxil
    Arm description
    Participants will receive a single oral dose of baloxavir marboxil on Day 1 (based on body weight). Oseltamivir matching placebo will also be administered orally twice daily (BID) for 5 days.
    Arm type
    Experimental

    Investigational medicinal product name
    Baloxavir Marboxil
    Investigational medicinal product code
    Other name
    Xofluza
    Pharmaceutical forms
    Granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received a single oral dose of baloxavir marboxil on Day 1 (based on body weight)

    Investigational medicinal product name
    Oseltamivir matching placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Oseltamivir matching placebo was administered orally twice daily (BID) for 5 days

    Arm title
    Oseltamivir
    Arm description
    Participants will receive oseltamivir orally BID for 5 days (based on body weight). Baloxavir marboxil matching placebo will also be administered orally on Day 1
    Arm type
    Active comparator

    Investigational medicinal product name
    Oseltamivir
    Investigational medicinal product code
    Other name
    Tamiflu
    Pharmaceutical forms
    Powder for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received oseltamivir orally BID for 5 days (based on body weight)

    Investigational medicinal product name
    Baloxavir marboxil matching placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Granules for oral suspension
    Routes of administration
    Oral use
    Dosage and administration details
    Baloxavir marboxil matching placebo was administered orally on Day 1

    Number of subjects in period 1
    Baloxavir Marboxil Oseltamivir
    Started
    115
    58
    Completed
    112
    57
    Not completed
    3
    1
         Consent withdrawn by subject
    2
    1
         Physician decision
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Baloxavir Marboxil
    Reporting group description
    Participants will receive a single oral dose of baloxavir marboxil on Day 1 (based on body weight). Oseltamivir matching placebo will also be administered orally twice daily (BID) for 5 days.

    Reporting group title
    Oseltamivir
    Reporting group description
    Participants will receive oseltamivir orally BID for 5 days (based on body weight). Baloxavir marboxil matching placebo will also be administered orally on Day 1

    Reporting group values
    Baloxavir Marboxil Oseltamivir Total
    Number of subjects
    115 58 173
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    9 7 16
        Children (2-11 years)
    106 51 157
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    0 0 0
        From 65-84 years
    0 0 0
        85 years and over
    0 0 0
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    6.10 ( 2.90 ) 6.02 ( 3.20 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    60 32 92
        Male
    55 26 81
    Race/Ethnicity, Customized
    Units: Subjects
        American Indian or Alaska Native
    1 0 1
        Asian
    1 0 1
        Black or African American
    6 5 11
        Native Hawaiian or other Pacific Islander
    0 1 1
        White
    98 51 149
        Multiple
    4 0 4
        Unknown
    5 1 6
    Race/Ethnicity, Customized
    Units: Subjects
        Hispanic or Latino
    52 27 79
        Not Hispanic or Latino
    63 31 94

    End points

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    End points reporting groups
    Reporting group title
    Baloxavir Marboxil
    Reporting group description
    Participants will receive a single oral dose of baloxavir marboxil on Day 1 (based on body weight). Oseltamivir matching placebo will also be administered orally twice daily (BID) for 5 days.

    Reporting group title
    Oseltamivir
    Reporting group description
    Participants will receive oseltamivir orally BID for 5 days (based on body weight). Baloxavir marboxil matching placebo will also be administered orally on Day 1

    Primary: Percentage of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)

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    End point title
    Percentage of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs) [1]
    End point description
    An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not considered related to the medicinal (investigational) product. A serious adverse event (SAE) is any significant hazard, contraindication, side effect that is fatal or life-threatening, requires hospitalization or prolongation of an existing hospitalization, results in persistent or significant disability/ incapacity, is a congenital anomaly/ birth defect, is medically significant or requires intervention to prevent one or other of the outcomes listed above.
    End point type
    Primary
    End point timeframe
    Up to Day 29
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive stats only. No statistical analyses were pre-defined.
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    115
    58
    Units: percentage of participants
    number (not applicable)
        Adverse Events (AEs)
    46.1
    53.4
        Serious Adverse Events (SAEs)
    0
    0
    No statistical analyses for this end point

    Secondary: Plasma Concentrations of Baloxavir Marboxil - Sparse PK Population

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    End point title
    Plasma Concentrations of Baloxavir Marboxil - Sparse PK Population [2]
    End point description
    Results provided by body-weight groups for participants in the Baloxavir Marboxil arm. Values below lower limit of quantification (0.5 ng/mL) are set to zero. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Days 1 (Post-Dose), 2, 4, 6 and 10
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    97
    Units: ng/mL
    arithmetic mean (standard deviation)
        5 - <10 kg (Day 1) (n=1)
    0.000 ( 99999 )
        5 - <10 kg (Day 2) (n=1)
    0.000 ( 99999 )
        5 - <10 kg (Day 4) (n=0)
    99999 ( 99999 )
        5 - <10 kg (Day 6) (n=1)
    0.000 ( 99999 )
        5 - <10 kg (Day 10) (n=0)
    99999 ( 99999 )
        10 - <15 kg (Day 1) (n=16)
    0.073 ( 0.2001 )
        10 - <15 kg (Day 2) (n=7)
    0.000 ( 0.0000 )
        10 - <15 kg (Day 4) (n=9)
    0.000 ( 0.0000 )
        10 - <15 kg (Day 6) (n=13)
    0.000 ( 0.0000 )
        10 - <15 kg (Day 10)(n=3)
    0.000 ( 0.0000 )
        15 - <20 kg (Day 1) (n=22)
    0.090 ( 0.2386 )
        15 - <20 kg (Day 2) (n=13)
    0.000 ( 0.0000 )
        15 - <20 kg (Day 4) (n=7)
    0.000 ( 0.0000 )
        15 - <20 kg (Day 6) (n=17)
    0.000 ( 0.0000 )
        15 - <20 kg (Day 10) (n=3)
    0.000 ( 0.0000 )
        >=20 kg (Day 1) (n=58)
    0.048 ( 0.1936 )
        >=20 kg (Day 2) (n=34)
    0.000 ( 0.0000 )
        >=20 kg (Day 4) (n=25)
    0.000 ( 0.0000 )
        >=20 kg (Day 6) (n=56)
    0.000 ( 0.0000 )
        >=20 kg (Day 10) (n=6)
    0.000 ( 0.0000 )
    No statistical analyses for this end point

    Secondary: Plasma Concentrations of S-033447 - Sparse PK Population

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    End point title
    Plasma Concentrations of S-033447 - Sparse PK Population [3]
    End point description
    Results provided by body-weight groups for participants in the Baloxavir Marboxil arm. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Days 1 (Post-Dose), 2, 4, 6 and 10
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    97
    Units: ng/mL
    arithmetic mean (standard deviation)
        5 - <10 kg (Day 1) (n=1)
    45.700 ( 99999 )
        5 - <10 kg (Day 2) (n=1)
    45.800 ( 99999 )
        5 - <10 kg (Day 4) (n=0)
    99999 ( 99999 )
        5 - <10 kg (Day 6) (n=1)
    3.110 ( 99999 )
        5 - <10 kg (Day 10) (n=0)
    99999 ( 99999 )
        10 - <15 kg (Day 1) (n=16)
    49.084 ( 53.6689 )
        10 - <15 kg (Day 2) (n=7)
    42.900 ( 16.5227 )
        10 - <15 kg (Day 4) (n=9)
    9.233 ( 5.3879 )
        10 - <15 kg (Day 6) (n=13)
    2.965 ( 1.6480 )
        10 - <15 kg (Day 10) (n=3)
    0.367 ( 0.6351 )
        15 - <20 kg (Day 1) (n=22)
    64.160 ( 73.6320 )
        15 - <20 kg (Day 2) (n=13)
    67.729 ( 46.7346 )
        15 - <20 kg (Day 4) (n=7)
    15.840 ( 10.8285 )
        15 - <20 kg (Day 6) (n=17)
    4.829 ( 3.6562 )
        15 - <20 kg (Day 10) (n=3)
    1.110 ( 1.9226 )
        >=20 kg (Day 1) (n=58)
    29.899 ( 26.1558 )
        >=20 kg (Day 2) (n=34)
    56.287 ( 40.4073 )
        >=20 kg (Day 4) (n=25)
    18.674 ( 11.2179 )
        >=20 kg (Day 6) (n=56)
    7.397 ( 5.0530 )
        >=20 kg (Day 10) (n=6)
    3.953 ( 2.2536 )
    No statistical analyses for this end point

    Secondary: Plasma Concentrations of Baloxavir Marboxil - Extensive PK Population

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    End point title
    Plasma Concentrations of Baloxavir Marboxil - Extensive PK Population [4]
    End point description
    Results provided by body-weight groups for participants in the Baloxavir Marboxil arm. Values below lower limit of quantification (0.5 ng/mL) are set to zero. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Days 1 (Post-Dose), 2, 4, 6 and 10
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    19
    Units: ng/mL
    arithmetic mean (standard deviation)
        Day 1, 0.5 - 2 hrs (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 1, 4 hrs (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 1, 6 hrs (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 2 (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 4 (5 - <10 kg ) (n=0)
    99999 ( 99999 )
        Day 6 (5 - <10 kg ) (n=0)
    99999 ( 99999 )
        Day 10 (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 1, 0.5 - 2 hrs (10 - <15 kg) (n=4)
    0.000 ( 0.0000 )
        Day 1, 4 hrs (10 - <15 kg) (n=2)
    0.000 ( 0.0000 )
        Day 1, 6 hrs (10 - <15 kg) (n=1)
    0.000 ( 99999 )
        Day 2 (10 - <15 kg) (n=3)
    0.000 ( 0.0000 )
        Day 4 (10 - <15 kg) (n=1)
    0.000 ( 99999 )
        Day 6 (10 - <15 kg) (n=3)
    0.000 ( 0.0000 )
        Day 10 (10 - <15 kg ) (n=1)
    0.000 ( 99999 )
        Day 1, 0.5 - 2 hrs (15 - <20 kg) (n=4)
    0.000 ( 0.0000 )
        Day 1, 4 hrs (15 - <20 kg) (n=1)
    0.000 ( 99999 )
        Day 1, 6 hrs (15 - <20 kg) (n=1)
    0.000 ( 99999 )
        Day 2 (15 - <20 kg) (n=2)
    0.000 ( 0.0000 )
        Day 4 (15 - <20 kg) (n=1)
    0.000 ( 99999 )
        Day 6 (15 - <20 kg) (n=3)
    0.000 ( 0.0000 )
        Day 10 (15 - <20 kg) (n=0)
    99999 ( 99999 )
        Day 1, 0.5 - 2 hrs (>=20 kg) (n=10)
    0.051 ( 0.1600 )
        Day 1, 4 hrs (>=20 kg) (n=9)
    0.062 ( 0.1863 )
        Day 1, 6 hrs ((>=20 kg) (n=6)
    0.000 ( 0.0000 )
        Day 2 (>=20 kg) (n=5)
    0.000 ( 0.0000 )
        Day 4 (>=20 kg) (n=4)
    0.000 ( 0.0000 )
        Day 6 (>=20 kg) (n=9)
    0.000 ( 0.0000 )
        Day 10 (>=20 kg) (n=0)
    99999 ( 99999 )
    No statistical analyses for this end point

    Secondary: Plasma Concentrations of S-033447 - Extensive PK Population

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    End point title
    Plasma Concentrations of S-033447 - Extensive PK Population [5]
    End point description
    Results provided by body-weight groups for participants in the Baloxavir Marboxil arm. Values below lower limit of quantification (0.5 ng/mL) are set to zero. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Days 1 (Post-Dose), 2, 4, 6 and 10
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    19
    Units: ng/mL
    arithmetic mean (standard deviation)
        Day 1, 0.5 - 2 hrs (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 1, 4 hrs (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 1, 6 hrs (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 2 (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 4 (5 - <10 kg ) (n=0)
    99999 ( 99999 )
        Day 6 (5 - <10 kg ) (n=0)
    99999 ( 99999 )
        Day 10 (5 - <10 kg) (n=0)
    99999 ( 99999 )
        Day 1, 0.5 - 2 hrs (10 - <15 kg) (n=4)
    10.768 ( 14.7987 )
        Day 1, 4 hrs (10 - <15 kg) (n=2)
    49.500 ( 13.0108 )
        Day 1, 6 hrs (10 - <15 kg) (n=1)
    41.000 ( 99999 )
        Day 2 (10 - <15 kg) (n=3)
    28.933 ( 14.7514 )
        Day 4 (10 - <15 kg) (n=1)
    2.230 ( 99999 )
        Day 6 (10 - <15 kg) (n=3)
    3.131 ( 2.2828 )
        Day 10 (10 - <15 kg ) (n=1)
    0.000 ( 99999 )
        Day 1, 0.5 - 2 hrs (15 - <20 kg) (n=4)
    93.883 ( 152.5431 )
        Day 1, 4 hrs (15 - <20 kg) (n=1)
    72.900 ( 99999 )
        Day 1, 6 hrs (15 - <20 kg) (n=1)
    80.300 ( 99999 )
        Day 2 (15 - <20 kg) (n=2)
    42.640 ( 47.6024 )
        Day 4 (15 - <20 kg) (n=1)
    12.200 ( 99999 )
        Day 6 (15 - <20 kg) (n=3)
    2.663 ( 1.5387 )
        Day 10 (15 - <20 kg) (n=0)
    99999 ( 99999 )
        Day 1, 0.5 - 2 hrs (>=20 kg) (n=10)
    19.923 ( 27.0980 )
        Day 1, 4 hrs (>=20 kg) (n=9)
    69.198 ( 55.7220 )
        Day 1, 6 hrs ((>=20 kg) (n=6)
    65.527 ( 43.0799 )
        Day 2 (>=20 kg) (n=5)
    57.980 ( 37.8922 )
        Day 4 (>=20 kg) (n=4)
    21.775 ( 3.7968 )
        Day 6 (>=20 kg) (n=9)
    6.240 ( 3.3702 )
        Day 10 (>=20 kg) (n=0)
    99999 ( 99999 )
    No statistical analyses for this end point

    Secondary: Time to Alleviation of Influenza Signs and Symptoms

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    End point title
    Time to Alleviation of Influenza Signs and Symptoms
    End point description
    Time to alleviation of influenza signs and symptoms is defined as the length of time taken from the start of treatment to the point at which all of the following criteria are met and remain so for at least 21.5 hours: - A score of 0 (no problem) or 1 (minor problem) for cough and nasal symptoms (items 14 and 15 of the Canadian Acute Respiratory Illness and Flu Scale [CARIFS]) - A “yes” response to the following question on the CARIFS: “Since the last assessment has the subject been able to return to day care/school, or resume his or her normal daily activity in the same way as performed prior to developing the flu?” - First return to afebrile state (tympanic temperature ≤37.2 degree Celsius [°C])
    End point type
    Secondary
    End point timeframe
    Up to Day 15
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    80
    43
    Units: hours
        median (confidence interval 95%)
    138.1 (116.6 to 163.2)
    150.0 (115.0 to 165.7)
    No statistical analyses for this end point

    Secondary: Duration of Fever

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    End point title
    Duration of Fever
    End point description
    Length of time taken by participants to return to afebrile state [tympanic temperature ≤ 37.2°C] and remaining so for at least 21.5 hours.
    End point type
    Secondary
    End point timeframe
    Up to Day 15
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    80
    43
    Units: hours
        median (confidence interval 95%)
    41.2 (24.5 to 45.7)
    46.8 (30.0 to 53.5)
    No statistical analyses for this end point

    Secondary: Duration of Symptoms

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    End point title
    Duration of Symptoms
    End point description
    The clinical efficacy of baloxavir marboxil is evaluated by duration of symptoms i.e., alleviation of all symptoms as defined by a score of 0 [no problem] or 1 [minor problem] and remaining so for at least 21.5 hours, for all 18 symptoms specified in the CARIFS questionnaire).
    End point type
    Secondary
    End point timeframe
    Up to Day 15
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    80
    43
    Units: hours
        median (confidence interval 95%)
    66.4 (43.7 to 76.4)
    67.9 (45.8 to 88.7)
    No statistical analyses for this end point

    Secondary: Time to Return to Normal Health and Activity

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    End point title
    Time to Return to Normal Health and Activity
    End point description
    Time to Return to Normal health and activity' is identified by a 'Yes' response to the following question on the CARIFS: "Since the last assessment has the patient been able to return to day care/school, or resume his or her normal daily activity in the same way as performed prior to developing the flu?"
    End point type
    Secondary
    End point timeframe
    Up to Day 15
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    80
    43
    Units: hours
        median (confidence interval 95%)
    116.5 (94.9 to 138.0)
    111.6 (80.8 to 138.3)
    No statistical analyses for this end point

    Secondary: Frequency of Influenza-Related Complications

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    End point title
    Frequency of Influenza-Related Complications
    End point description
    Influenza related complications include death, hospitalization, radiologically confirmed pneumonia, bronchitis, sinusitis, otitis media, encephalitis/encephalopathy, febrile seizures, myositis.
    End point type
    Secondary
    End point timeframe
    Up to Day 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    81
    43
    Units: count of events
        Total
    6
    4
        Death
    0
    0
        Hospitalization
    0
    0
        Sinusitis
    1
    0
        Otitis Media
    3
    3
        Pneumonia
    1
    0
        Bronchitis
    1
    0
        Encephalitis/Encephalopathy
    0
    0
        Febrile Seizures
    0
    1
        Myositis
    0
    0
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Influenza-Related Complications

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    End point title
    Percentage of Participants with Influenza-Related Complications
    End point description
    Influenza related complications include death, hospitalization, radiologically confirmed pneumonia, bronchitis, sinusitis, otitis media, encephalitis/encephalopathy, febrile seizures, myositis.
    End point type
    Secondary
    End point timeframe
    Up to Day 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    81
    43
    Units: percentage of participants
    number (not applicable)
        Total
    7.4
    7.0
        Death
    0
    0
        Hospitalization
    0
    0
        Sinusitis
    1.2
    0
        Otitis Media
    3.7
    4.7
        Pneumonia
    1.2
    0
        Bronchitis
    1.2
    0
        Encephalitis/Encephalopathy
    0
    0
        Febrile Seizures
    0
    2.3
        Myositis
    0
    0
    No statistical analyses for this end point

    Secondary: Percentage of Participants Requiring Antibiotics

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    End point title
    Percentage of Participants Requiring Antibiotics
    End point description
    End point type
    Secondary
    End point timeframe
    Up to Day 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    81
    43
    Units: percentage of participants
    number (not applicable)
        Total
    4.9
    4.7
        Bronchitis
    0
    0
        Otitis Media
    2.5
    4.7
        Pneumonia
    1.2
    0
        Sinusitis
    1.2
    0
    No statistical analyses for this end point

    Secondary: Time to Cessation of Viral Shedding by Virus Titer

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    End point title
    Time to Cessation of Viral Shedding by Virus Titer
    End point description
    Time to cessation of viral shedding by virus titer is defined as the time, in hours, between the initiation of any study treatment and first time when the influenza virus titer is below the limit of detection.
    End point type
    Secondary
    End point timeframe
    Day 1 - Day 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    67
    37
    Units: hours
    median (confidence interval 95%)
        Virus Titer
    24.2 (23.5 to 24.6)
    75.8 (68.9 to 97.8)
    No statistical analyses for this end point

    Secondary: Time to Cessation of Viral Shedding by RT-PCR

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    End point title
    Time to Cessation of Viral Shedding by RT-PCR
    End point description
    Time to cessation of viral shedding by RT-PCR, in hours, is defined as the time between the initiation of any study treatment and first time when the virus RNA by RT-PCR is below the limit of detection.
    End point type
    Secondary
    End point timeframe
    Day 1 - Day 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    76
    39
    Units: hours
        median (confidence interval 95%)
    242.5 (235.8 to 262.8)
    238.9 (214.0 to 286.7)
    No statistical analyses for this end point

    Secondary: Change from Baseline in Influenza Virus Titer at Day 2, 4, 6, 10, 15, 29

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    End point title
    Change from Baseline in Influenza Virus Titer at Day 2, 4, 6, 10, 15, 29
    End point description
    Influenza virus titer (log10TCID50/ML) is the quantity of influenza virus in a given volume within the samples obtained from nasal swabs. If influenza virus titer was less than the lower limit of quantification, the virus titer was imputed as 0.749 (log10TCID50/mL). A lower value indicates lower viral titer.
    End point type
    Secondary
    End point timeframe
    Baseline, Day 2, 3 (optional), 4, 6, 10, 15 (optional), 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    67
    38
    Units: log10TCID50/ML
    arithmetic mean (standard deviation)
        Baseline (Baloxvir Marboxil n=67/Osetamivir n=38)
    4.43 ( 1.36 )
    4.27 ( 1.48 )
        Day 2 (Baloxvir Marboxil n=64/ Osetamivir n=37)
    -3.59 ( 1.34 )
    -1.79 ( 1.54 )
        Day 3 (Baloxvir Marboxil n=3 / Osetamivir n=2)
    -2.83 ( 0.58 )
    -2.63 ( 0.88 )
        Day 4 (Baloxvir Marboxil n=61 / Osetamivir n=31)
    -3.53 ( 1.38 )
    -3.27 ( 1.54 )
        Day 6 (Baloxvir Marboxil n=63 / Osetamivir n=35)
    -3.55 ( 1.32 )
    -3.52 ( 1.50 )
        Day 10 (Baloxvir Marboxil n=4 / Osetamivir n=4)
    -3.66 ( 1.40 )
    -3.50 ( 1.42 )
        Day 15 (Baloxvir Marboxil n=4 / Osetamivir n=4)
    -3.75 ( 0.54 )
    -3.63 ( 1.45 )
        Day 29 (Baloxvir Marboxil n=4 / Osetamivir n=4)
    -3.50 ( 1.43 )
    -3.75 ( 1.19 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in the Amount of Virus RNA (RT-PCR) at Day 2, 4, 6, 10, 15, 29

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    End point title
    Change from Baseline in the Amount of Virus RNA (RT-PCR) at Day 2, 4, 6, 10, 15, 29
    End point description
    If the amount of virus RNA was less than the lower limit of quantification, the amount of virus RNA was imputed as 2.18 for flu A and 2.93 for flu B (log10 virus particles/mL). Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Baseline, Day 2, 3 (optional), 4, 6, 10, 15 (optional), 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    76
    40
    Units: log10 virus particles/mL
    arithmetic mean (standard deviation)
        Baseline (Baloxvir Marboxil n=76/Osetamivir n=40)
    6.46 ( 1.50 )
    6.86 ( 1.02 )
        Day 2 (Baloxvir Marboxil n=70 / Osetamivir n=39)
    -1.74 ( 1.13 )
    -1.12 ( 1.12 )
        Day 3 (Baloxvir Marboxil n=4 / Osetamivir n=2)
    -1.78 ( 1.50 )
    -2.21 ( 0.94 )
        Day 4 (Baloxvir Marboxil n=61 / Osetamivir n=30)
    -2.40 ( 1.50 )
    -2.47 ( 1.35 )
        Day 6 (Baloxvir Marboxil n=60 / Osetamivir n=30)
    -2.73 ( 1.78 )
    -3.32 ( 1.27 )
        Day 10 (Baloxvir Marboxil n=35 / Osetamivir n=15)
    -3.55 ( 1.62 )
    -3.81 ( 1.19 )
        Day 15 (Baloxvir Marboxil n=2 / Osetamivir n=1)
    -1.24 ( 3.06 )
    -4.44 ( 99999 )
        Day 29 (Baloxvir Marboxil n=1 / Osetamivir n=0)
    2.18 ( 99999 )
    99999 ( 99999 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Positive Influenza Virus Titer at Day 2, 4, 6, 10

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    End point title
    Percentage of Participants with Positive Influenza Virus Titer at Day 2, 4, 6, 10
    End point description
    The percentage is based on the number of patients with virus titer data at each time point
    End point type
    Secondary
    End point timeframe
    Baseline, Day 2, 3 (optional), 4, 6, 10
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    67
    38
    Units: percentage of participants
    number (not applicable)
        Baseline
    100
    100
        Day 2
    15.6
    75.7
        Day 3 (optional)
    33.3
    50.0
        Day 4
    26.2
    29.0
        Day 6
    12.7
    5.7
        Day 10
    1.6
    0
    No statistical analyses for this end point

    Secondary: Percentage of Participants Positive by RT-PCR at Day 2, 4, 6, 10, 15, 29

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    End point title
    Percentage of Participants Positive by RT-PCR at Day 2, 4, 6, 10, 15, 29
    End point description
    The percentage is based on the number of patients with RT-PCR data at each time point
    End point type
    Secondary
    End point timeframe
    Day 2, 3 (optional), 4, 6, 10, 15 (optional), 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    76
    40
    Units: percentage of participants
    number (not applicable)
        Baseline
    100
    100
        Day 2
    95.9
    100
        Day 3 (optional)
    100
    100
        Day 4
    89.9
    97.0
        Day 6
    83.1
    75.7
        Day 10
    46.5
    44.1
        Day 15 (optional)
    40.0
    25.0
        Day 29
    25.0
    0
    No statistical analyses for this end point

    Secondary: Area Under the Curve in Virus Titer

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    End point title
    Area Under the Curve in Virus Titer
    End point description
    Area under the curve (AUC) in virus titer was calculated using the trapezoidal method.
    End point type
    Secondary
    End point timeframe
    Day 1 - Day 29
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    67
    37
    Units: log₁₀[TCID₅₀/mL]*hours
        arithmetic mean (standard deviation)
    -863.81 ( 543.37 )
    -849.29 ( 684.43 )
    No statistical analyses for this end point

    Secondary: Area Under the Curve in the Amount of Virus RNA (RT-PCR)

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    End point title
    Area Under the Curve in the Amount of Virus RNA (RT-PCR)
    End point description
    AUC in virus RNA (RT-PCR) is defined as AUC of change from baseline in the amount of virus RNA (RT-PCR) from Day 1 to Day 10. AUC is calculated using the trapezoidal method similar to AUC in virus titer.
    End point type
    Secondary
    End point timeframe
    Day 1 - Day 10
    End point values
    Baloxavir Marboxil Oseltamivir
    Number of subjects analysed
    75
    39
    Units: log₁₀ VPs/mL*hours
        arithmetic mean (standard deviation)
    -381.53 ( 338.53 )
    -353.31 ( 304.01 )
    No statistical analyses for this end point

    Secondary: Area Under the Concentration to Time Curve from Time 0 to Infinity (AUC0-inf) of baloxavir marboxil

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    End point title
    Area Under the Concentration to Time Curve from Time 0 to Infinity (AUC0-inf) of baloxavir marboxil [6]
    End point description
    End point type
    Secondary
    End point timeframe
    Up to Day 10
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    0 [7]
    Units: ng.hr/ml
        arithmetic mean (standard deviation)
    ( )
    Notes
    [7] - Not estimable as a large number of concentrations were below the lower limit of quantification
    No statistical analyses for this end point

    Secondary: Area Under the Concentration to Time Curve from Time 0 to Infinity (AUC0-inf) of S-033447

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    End point title
    Area Under the Concentration to Time Curve from Time 0 to Infinity (AUC0-inf) of S-033447 [8]
    End point description
    Dose groups correspond to body-weight groups. 2mg/kg dose was used for subjects <20 kgs and 40 mg dose was used for subjects >20 kgs. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Up to Day 10
    Notes
    [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    95
    Units: ng.hr/mL
    arithmetic mean (standard deviation)
        Non-Asian - 2 mg/kg (n=36)
    4050 ( 2080 )
        Asian - 40 mg (n=1)
    6600 ( 99999 )
        Non-Asian - 40 mg (n=58)
    4390 ( 2080 )
    No statistical analyses for this end point

    Secondary: Maximum Plasma Concentration (Cmax) of baloxavir marboxil

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    End point title
    Maximum Plasma Concentration (Cmax) of baloxavir marboxil [9]
    End point description
    End point type
    Secondary
    End point timeframe
    Up to Day 10
    Notes
    [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    0 [10]
    Units: ng/mL
        arithmetic mean (standard deviation)
    ( )
    Notes
    [10] - Not estimable as a large number of concentrations were below the lower limit of quantification
    No statistical analyses for this end point

    Secondary: Maximum Plasma Concentration (Cmax) of S-033447

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    End point title
    Maximum Plasma Concentration (Cmax) of S-033447 [11]
    End point description
    Dose groups correspond to body-weight groups. 2mg/kg dose was used for subjects <20 kgs and 40 mg dose was used for subjects >20 kgs. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Up to Day 10
    Notes
    [11] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    95
    Units: ng/mL
    arithmetic mean (standard deviation)
        Non-Asian - 2 mg/kg (n=36)
    109 ( 55.3 )
        Asian - 40 mg (n=1)
    110 ( 99999 )
        Non-Asian - 40 mg (n=58)
    83.2 ( 36.5 )
    No statistical analyses for this end point

    Secondary: Time to Maximum Plasma Concentration (Tmax) of baloxavir marboxil

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    End point title
    Time to Maximum Plasma Concentration (Tmax) of baloxavir marboxil [12]
    End point description
    End point type
    Secondary
    End point timeframe
    Up to Day 10
    Notes
    [12] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    0 [13]
    Units: hr
        arithmetic mean (standard deviation)
    ( )
    Notes
    [13] - Not estimable as a large number of concentrations were below the lower limit of quantification
    No statistical analyses for this end point

    Secondary: Time to Maximum Plasma Concentration (Tmax) of S-033447

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    End point title
    Time to Maximum Plasma Concentration (Tmax) of S-033447 [14]
    End point description
    Dose groups correspond to body-weight groups. 2mg/kg dose was used for subjects <20 kgs and 40 mg dose was used for subjects >20 kgs. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    Up to Day 10
    Notes
    [14] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    95
    Units: hr
    arithmetic mean (standard deviation)
        Non-Asian - 2 mg/kg (n=36)
    4.12 ( 2.07 )
        Asian - 40 mg (n=1)
    5.50 ( 99999 )
        Non-Asian - 40 mg (n=58)
    5.55 ( 3.79 )
    No statistical analyses for this end point

    Secondary: Plasma Concentrations of Baloxavir Marboxil by Dosage

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    End point title
    Plasma Concentrations of Baloxavir Marboxil by Dosage [15]
    End point description
    End point type
    Secondary
    End point timeframe
    24, 72, 96 and 240 hours post-dose
    Notes
    [15] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    0 [16]
    Units: ng/mL
        arithmetic mean (standard deviation)
    ( )
    Notes
    [16] - Not estimable as a large number of concentrations were below the lower limit of quantification
    No statistical analyses for this end point

    Secondary: Plasma Concentrations of S-033447 by Dosage

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    End point title
    Plasma Concentrations of S-033447 by Dosage [17]
    End point description
    Dose groups correspond to body-weight groups. 2mg/kg dose was used for subjects <20 kgs and 40 mg dose was used for subjects >20 kgs. Here 99999 represents results data which was not estimable due to low number of events.
    End point type
    Secondary
    End point timeframe
    24, 72, 96 and 240 hours post-dose
    Notes
    [17] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is specific to the arm - Baloxavir Marboxil only.
    End point values
    Baloxavir Marboxil
    Number of subjects analysed
    95
    Units: ng/mL
    arithmetic mean (standard deviation)
        24 - Non-Asian - 2 mg/kg (n=36)
    55.7 ( 28.1 )
        24 - Asian - 40 mg (n=1)
    75.2 ( 99999 )
        24 - Non-Asian - 40 mg (n=58)
    53.2 ( 22.4 )
        72 - Non-Asian - 2 mg/kg (n=36)
    13.2 ( 7.15 )
        72 - Asian - 40 mg (n=1)
    28.9 ( 99999 )
        72 - Non-Asian - 40 mg (n=58)
    17.90 ( 8.910 )
        96 - Non-Asian - 2 mg/kg (n=36)
    7.61 ( 4.400 )
        96 - Asian - 40 mg (n=1)
    19.0 ( 99999 )
        96 - Non-Asian - 40 mg (n=58)
    11.3 ( 6.160 )
        240 - Non-Asian - 2 mg/kg (n=36)
    0.989 ( 0.887 )
        240 - Asian - 40 mg (n=1)
    3.31 ( 99999 )
        240 - Non-Asian - 40 mg (n=58)
    11.3 ( 6.160 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From baseline (Day 1) until 28 days after the last dose of study drug (29 days)
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    Baloxavir Marboxil
    Reporting group description
    Participants will receive a single oral dose of baloxavir marboxil on Day 1 (based on body weight). Oseltamivir matching placebo will also be administered orally twice daily (BID) for 5 days.

    Reporting group title
    Oseltamivir
    Reporting group description
    Participants will receive oseltamivir orally BID for 5 days (based on body weight). Baloxavir marboxil matching placebo will also be administered orally on Day 1

    Serious adverse events
    Baloxavir Marboxil Oseltamivir
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 115 (0.00%)
    0 / 58 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Baloxavir Marboxil Oseltamivir
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    15 / 115 (13.04%)
    13 / 58 (22.41%)
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    6 / 115 (5.22%)
    1 / 58 (1.72%)
         occurrences all number
    6
    1
    Vomiting
         subjects affected / exposed
    7 / 115 (6.09%)
    9 / 58 (15.52%)
         occurrences all number
    7
    10
    Infections and infestations
    Otitis Media
         subjects affected / exposed
    3 / 115 (2.61%)
    4 / 58 (6.90%)
         occurrences all number
    3
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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