(P-017) Comparison of the Incidence of Bleeding Between Anti-influenza Drugs Among Outpatients for the Influenza Virus Infection: A Retrospective Study Using an Employment-based Health Insurance Claims Database in Japan

Background: Bleeding events have been alerted in the Japanese package inserts of some anti-Influenza drugs, including baloxavir marboxil (BXM) and oseltamivir (OTV). However, there are few reports investigating the incidence of bleeding events during the treatment with anti-influenza drugs.

Objectives: To compare the incidence of the bleeding events among influenza patients treated with different types of anti-influenza drugs and untreated patients.

Methods: This study is a retrospective study using an employment-based health insurance claims database: JMDC Claims Database. Outpatients with influenza episodes recoded from 1st Oct 2018 to 11th Apr 2019 were included in this study. The 20-days incidence rates of total bleeding, intracranial bleeding, gastrointestinal bleeding, and other bleedings were compared between BXM versus OTV, zanamivir (ZNV), peramivir (PRV), laninamivir (LNV), or untreated groups. We employed the exact matching to adjust for the patient backgrounds.

Results: Of the 510,008 influenza episodes, 498,237 were prescribed an anti-influenza drug (BXM, 207,630; OTV, 143,722; ZNV, 28,208; PRV, 5,304; LNV, 113,373) and 11,771 were untreated. The crude incidence rates of total bleeding were similar among the treatment groups, with slightly higher incidence rates in the PRV group and the untreated (0.19% in BXM, OTV, ZNV and LNV groups, and 0.21% in PRV group and the untreated). After exact matching, the incidences of bleeding events for BXM group were also similar with other treatment groups and the untreated.

Conclusions: The incidences of bleeding were similar for anti-influenza drugs and the untreated. The present study did not show the evidence to suggest the difference in incidences of the bleeding events among the influenza patients treated with anti-influenza drugs.