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Baloxavir is a first-in-class antiviral agent and the active metabolite of the prodrug baloxavir marboxil. It functions as a small molecule inhibitor of the influenza virus's cap-dependent endonuclease (CEN), which is located within the polymerase acidic (PA) subunit of the viral RNA polymerase complex. By binding to the PA subunit, baloxavir prevents the "cap-snatching" process, where the virus cleaves the 5' caps from host cellular pre-mRNAs to prime its own mRNA synthesis. This mechanism effectively halts viral transcription and replication early in the life cycle. Baloxavir demonstrates potent activity against both influenza A and B viruses, including strains resistant to neuraminidase inhibitors. It was discovered by Shionogi and is developed in collaboration with Roche.
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