A new flu drug

NICK EICHER, HOST: It’s Thursday the 8th of November, 2018. Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Nick Eicher.

MARY REICHARD, HOST: And I’m Mary Reichard.

Well, flu season is near. For the first time in 20 years, the Food and Drug Administration has approved a new antiviral treatment for influenza. It’s named Xofluza and it’s for people over age 12 who’ve had symptoms less than two days.

WORLD Radio correspondent Charles Horton is here to talk about it. He’s a medical doctor in the know.

First of all, Dr. Horton, what makes this treatment different from the others?  

CHARLES HORTON, REPORTER: So, Xofluza differs from Tamiflu—or Oseltamivir—which is the current pill that one would take for the flu, in that it works in a different way. Early research studies seem to show that it’s at least as effective as Tamiflu and it’s a lot more convenient because there’s only one pill, not one pill per day or one pill per 12 hours, but a single pill is what you get from the pharmacy.

REICHARD: And does it work on flu strains that are resistant to Tamiflu?

HORTON: Maybe. We don’t know yet, but I suspect it would because it works in a different way. Typically, if a bacterium is resistant to one antibiotic, this is an antiviral, not an antibiotic, but the same principle probably applies, it may well not be resistant to another. Switching classes often helps.

REICHARD: So what kind of relief might flu sufferers get from Xofluza?

HORTON: There are three things that they looked at in the study when they researched the drug. One was what they called TTAS or Time To Aleviation of Symptoms. In plain English, feeling better. This went down from 80 hours to 53 hours. Number two was the viral titer, which one doesn’t really feel the viral titer directly, but it’s proof that the drug is in fact getting rid of the virus. That went down and went down quickly. That’s a very good sign. And then the third thing that it looked at is when did patients stop the fancy term is “shedding virus.” In other words, when did they stop being contagious. And that also went down very nicely with the placebo, the sugar pill. It was 96 hours with Tamiflu, which was the old standard, it went down to 72 hours. With Xofluza, 24 hours. Nice.

REICHARD: So how much does it cost?

HORTON: Retail is $150. There is a coupon with certain restrictions and terms and so forth. Insurance may cover it.

REICHARD: And what would happen—suppose I want to experiment here—if I took both Xofluza and Tamiflu? Any good from that?

HORTON: Research has not answered that yet. I’m curious! I expect that in the next year or two we’ll see a formal research study on that and, off the record, I’ll bet some doctors are planning to prescribe them together because they will probably have the unofficial research before the official.

REICHARD: And do I still need a flu shot with this?

HORTON: I would still recommend it—and I’ve already had mine. Xofluza makes flu shorter, but it doesn’t prevent it. So if you come down with flu symptoms, there is now a better way to shorten the misery, but I’d still rather prevent the misery myself.

REICHARD: And are there any areas where Xofluza might not be the right way to go?

HORTON: Compared to Tamiflu, which was the old drug, Tamiflu has a pediatric dosing. Xofluza is currently approved for people 12 and up, so if you have a child who is, say, immunocompromised and might need flu therapy, then probably Tamiflu would get the nod still. Likewise, there is a scenario where Tamiflu is given prophylactically, it’s given to prevent flu in cases, for example, where someone who would really, really do poorly with the flu, perhaps someone who’s debilitated, who’s frail, and now a family member comes home with flu, now what? In those scenarios, doctors will often prescribe prophylactic Tamiflu to try to prevent that person from catching it. There isn’t currently a prophylactic dosing with Xofluza.

REICHARD: Well, now, we know there are some people who have a problem with getting a flu shot for various reasons. Does this new drug offer a better treatment for flu than the shot?

HORTON: To me, no, in that the drug still has to be taken once you have the flu. I’d rather not start having the flu, personally, and being a doctor, I’m often exposed to it. But we have listeners in all walks of life, we have some listeners who feel strongly about vaccines, about the politics behind them, some people just don’t like getting a shot.

REICHARD: If I get the flu and take Xofluza within the two days of symptoms, can I just go back to regular life?

HORTON: Not quite so fast. Flu patients are still contagious, and the best remedy for spreading the flu still the oldest one: if there’s any way to do it, stay home while you’re sick. Chicken soup, orange juice, and a nice cozy blanket. And, maybe, a Xofluza tablet.

REICHARD: Dr. Charles Horton is our medical correspondent based in Pennsylvania. Doctor, as always, thanks for talking with us today.

HORTON: My pleasure.

(Genentech via AP) This undated product image provided by Genentech shows a box for Xofluza, a pill for shortening the duration and easing symptoms of the flu. 

WORLD Radio transcripts are created on a rush deadline. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of WORLD Radio programming is the audio record.

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