A Clinical Trial of Intravenous Peramivir Compared with Oral Oseltamivir for the Treatment of Seasonal Influenza in Hospitalized Adults

Ison, Michael G.; Hui, David S.; Clezy, Kate; O’Neil, Brian J.; Flynt, Amy; Collis, P.; Simon, Thomas; Alexander, W. James

doi:10.3851/imp2442

Cited by 58 publications

(84 citation statements)

References 31 publications

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“…The negativity rates were consistent, although somewhat lower than previously described for hospitalised patients (97-100% and 60-82%, respectively, on Day 4-5), which might be explained by the fewer LRTC cases (20-50%) in other cohorts [5][6][7]. Compared with our patients treated with oseltamivir, we found that the virological responses were generally similar [1,5,6,10]. Interestingly, when compared against the oseltamivir subgroup with LRTC, we observed a trend towards faster viral decline with peramivir.…”

Section: Discussionsupporting

confidence: 46%

“…There was a −2.0 log viral load reduction by Day 3 and −2.5 log by Day 5, and 94% and 44% achieved culture and RNA negativity, respectively, on Day 5. The negativity rates were consistent, although somewhat lower than previously described for hospitalised patients (97-100% and 60-82%, respectively, on Day 4-5), which might be explained by the fewer LRTC cases (20-50%) in other cohorts [5][6][7]. Compared with our patients treated with oseltamivir, we found that the virological responses were generally similar [1,5,6,10].…”

Section: Discussioncontrasting

confidence: 43%

“…Interestingly, when compared against the oseltamivir subgroup with LRTC, we observed a trend towards faster viral decline with peramivir. Two previous peramivir trials had indicated possible benefits in clinically unstable [6] and ICU patients [5], although statistically insignificant. In vitro susceptibility data have predicted little advantage of peramivir over oseltamivir in antiviral efficacy, except for influenza B [1,6,11].…”

Section: Discussionmentioning

confidence: 98%

“…therapy lies mainly with patients hospitalised with complicated diseases [4], such data are limited because of feasibility and ethical considerations for placebo-controlled studies. To date, only a few trials have been published on this rather heterogeneous population, which compared peramivir against institutional 'standard of care' treatment (in a milder non-NAI subgroup) [5], against oseltamivir (using lower-dose peramivir) [6], and between two i.v. dosing regimens [3,7].…”

Section: Introductionmentioning

confidence: 99%

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Virological response to peramivir treatment in adults hospitalised for influenza-associated lower respiratory tract infections

Lee

Chan

Tam

et al. 2016

International Journal of Antimicrobial Agents

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Section: Discussionsupporting

confidence: 46%

Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Virological response to peramivir treatment in adults hospitalised for influenza-associated lower respiratory tract infections

Lee

Chan

Tam

et al. 2016

International Journal of Antimicrobial Agents

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“…Ison et al26 conducted a multinational Phase II randomized, double-blind trial in seven countries to evaluate the efficacy and safety of intravenously administered peramivir compared to oral oseltamivir in 2007–2008, the prepandemic era. The 137 adult hospitalized patients with suspected acute seasonal influenza were randomized to 5-day treatments with intravenously administered peramivir (400 mg or 200 mg once daily) or oral oseltamivir (75 mg twice daily).…”

Section: Resultsmentioning

confidence: 99%

Safety and efficacy of peramivir for influenza treatment

Hata¹,

Akashi-Ueda²,

Takamatsu³

et al. 2014

DDDT

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ObjectiveThis report presents a review of the efficacy and safety of peramivir, a neuraminidase inhibitor that was granted Emergency Use Authorization by the US Food and Drug Administration (FDA) from October 23, 2009 to June 23, 2010 during the 2009 H1N1 pandemic.MethodsLiterature was accessed via PubMed (January 2000–April 2014) using several search terms: peramivir; BCX-1812; RWJ 270201; H1N1, influenza; antivirals; and neuraminidase inhibitors. The peramivir manufacturers, Shionogi and Co Ltd and BioCryst Pharmaceuticals, were contacted to obtain unpublished data and information presented at recent scientific meetings. Information was obtained from the Centers for Disease Control and Prevention (CDC) and from US FDA websites. English-language and Japanese-language reports in the literature were reviewed and selected based on relevance, along with information from the CDC, US FDA, and the drug manufacturers.ResultsWe obtained eleven clinical trial reports of intravenous peramivir, two of which described comparisons with oseltamivir. Seven of nine other recently reported published studies was a dose–response study. Clinical reports of critically ill patients and pediatric patients infected with pandemic H1N1 described that early treatment significantly decreased mortality. Peramivir administered at 300 mg once daily in adult patients with influenza significantly reduces the time to alleviation of symptoms or fever compared to placebo. It is likely to be as effective as other neuraminidase inhibitors.ConclusionAlthough peramivir shows efficacy for the treatment of seasonal and pH1N1 influenza, it has not received US FDA approval. Peramivir is used safely and efficiently in hospitalized adult and pediatric patients with suspected or laboratory-confirmed influenza. Peramivir might be a beneficial alternative antiviral treatment for many patients, including those unable to receive inhaled or oral neuraminidase inhibitors, or those requiring nonintravenous drug delivery.

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Comparison of Antiviral Agents for Seasonal Influenza Outcomes in Healthy Adults and Children

et al. 2021

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Key Points Question What antiviral agents for treating seasonal influenza are associated with the most safety and best outcomes among healthy adults and children? Findings This network meta-analysis of 26 randomized clinical trials, including 11 897 patients, found that antiviral agents were associated with significantly greater efficacy than placebo in shortening the duration of influenza symptoms; zanamivir was associated with the shortest time to alleviation of influenza symptoms. Baloxavir was associated with a lower occurrence of influenza-related complications than other treatments. Meaning These findings suggest that zanamivir may be initiated as soon as possible for patients with influenza-like illness; in those who may be at high risk of developing influenza-related complications, baloxavir should be considered.

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A Clinical Trial of Intravenous Peramivir Compared with Oral Oseltamivir for the Treatment of Seasonal Influenza in Hospitalized Adults

Abstract: Treatment of acute seasonal influenza in hospitalized adults with either peramivir or oseltamivir resulted in generally similar clinical outcomes. Treatment with peramivir was generally safe and well tolerated and could be of benefit in this population.

Cited by 58 publications

References 31 publications

Virological response to peramivir treatment in adults hospitalised for influenza-associated lower respiratory tract infections

Virological response to peramivir treatment in adults hospitalised for influenza-associated lower respiratory tract infections

Safety and efficacy of peramivir for influenza treatment

Comparison of Antiviral Agents for Seasonal Influenza Outcomes in Healthy Adults and Children

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