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

Liu, Jen Wei; Lin, Shen Hua; Wang, Lin Chien; Chiu, Hsin–Hui; Lee, Jen Ai

doi:10.1001/jamanetworkopen.2021.19151

Cited by 45 publications

(36 citation statements)

References 78 publications

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“…Moreover, it is also recommended that this high-risk group be treated with Oseltamivir or Zanamivir as soon as possible whenever they have uncomplicated illness due to confirmed or strongly suspected with virus infection [27].…”

Section: Discussionmentioning

confidence: 99%

Clinical Pathway for Influenza in the Elderly: A comprehensive management protocol of Malaysia

Tahir

Ismail

Aziz

et al. 2022

APJHM

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Introduction: The clinical pathway (CP) is one of the most recommended tools for ensuring the best quality of care and has been proven to reduce the cost and time spent in hospital. The development of a CP for influenza is crucial, especially for the elderly, as they are vulnerable to influenza-related complications. The main aim of this study was to provide a comprehensive protocol for each component of influenza management among the elderly in Malaysia. Methods: An expert group meeting was conducted involving family medicine specialists, public health specialists, geriatricians, respiratory physicians and infectious disease physicians. The CP was designed following a 6-step protocol: 1) Selection of expert panel, 2) discussion and information gathering, 3) development of CP draft, 4) refinement of CP draft, 5) implementation of CP, and 6) finalisation of CP. The CP for influenza was designed based on service type and disease severity. Results: The panel described both outpatient and inpatient CPs for managing elderly patients with influenza. The outpatient CP covered mild and moderate influenza cases, while the inpatient CP addressed the management of moderate and severe influenza. The estimated length of hospital stay for moderate and severe influenza cases with pneumonia was 6 and 14 days, respectively. Conclusions: The CP for influenza supports existing treatment according to illness severity leveraged on current clinical practice guidelines and the best-care practices in primary and tertiary care settings. Continuous use of the CP is required to assess its effectiveness, thereby enabling optimisation of the healthcare process in influenza treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical Pathway for Influenza in the Elderly: A comprehensive management protocol of Malaysia

Tahir

Ismail

Aziz

et al. 2022

APJHM

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“…Neben Oseltamivir stehen die weiteren Neuraminidase-Inhibitoren Peramivir und Zanamivir, sowie der Endonuklease-Inhibitor Baloxavir marboxil zu Verfügung. Eine kürzlich veröffentlichte Metaanalyse wertete 26 randomisiert kontrollierte Studien mit insgesamt 11 897 Patient*innen aus, welche die antiviralen Substanzen gegeneinander oder gegen Placebo verglichen haben 27 . Alle untersuchten Substanzen gingen mit einer Verkürzung der Zeit bis zur Symptombesserung einher.…”

Section: Therapieunclassified

Saisonale Influenza – Aktuelles zu Epidemiologie, Prävention und Therapie

Brehm

Hennigs

2022

Dtsch Med Wochenschr

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Was ist neu? Epidemiologie und Klinik Die im Rahmen der COVID-19-Pandemie ergriffenen Infektionsschutzmaßnahmen und Reisebeschränkungen haben auch die Übertragung saisonaler Influenzaviren stark eingeschränkt. Es muss jedoch davon ausgegangen werden, dass das Infektionsgeschehen in der kommenden Influenzasaison nach dem Wegfall dieser Maßnahmen wieder zunehmen wird. Koinfektionen von saisonalen Influenzaviren und SARS-CoV-2 sind möglich und gehen gegebenenfalls mit einem erhöhten Risiko für schwere Krankheitsverläufe einher. Influenza-Impfung Die STIKO empfiehlt seit 2021 ab einem Alter von 60 Jahren den Einsatz tetravalenter Hochdosis-Impfstoffe. Diese enthalten im Vergleich zu standarddosierten Impfstoffen die 4-fache Antigenmenge. Impfstoffe, die auf der mRNA-Technologie beruhen, sowie universelle Influenza-Impfstoffe befinden sich in klinischer Prüfung. Es besteht nun auch für Apotheker*innen die Möglichkeit, Grippeimpfungen unter bestimmten Auflagen durchzuführen. Therapie Für Patient*innen mit erhöhtem Risiko für einen schweren Verlauf wird weiterhin eine frühzeitige antivirale Therapie mit dem Neuraminidase-Inhibitor Oseltamivir empfohlen. Der Gemeinsame Bundesausschuss (G-BA) sieht für Baloxavir marboxil dagegen keinen Zusatznutzen hinsichtlich der Therapie der Influenzavirus-Infektion. Die aktuelle S3-Leitlinie „Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie“ gibt eine moderate Empfehlung zur antibakteriellen Behandlung hospitalisierter Patient*innen mit Influenza-Nachweis und nachgewiesenen pulmonalen Infiltraten. Der Grund dafür ist, dass eine bakterielle Superinfektion auch bei fehlendem mikrobiologischem Nachweis nicht ausgeschlossen werden kann und diese mit erhöhter Letalität einher geht.

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“…A recent clinical trial in Japan in children between 6 and 12 concluded that BXM was efficacious and safe for Japanese patients with influenza infection [24]. A comparison of the antiviral medicines in Japan showed that BXM reduced the rates of complications in patients suffering from flu [25]. The main concern remains the development of resistance, for which insufficient data are available for the moment.…”

Section: Medical Interestmentioning

confidence: 99%

Baloxavir Marboxil: An Original New Drug against Influenza

Dufrasne

2021

Pharmaceuticals

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Baloxavir marboxil is a new drug developed in Japan by Shionogi to treat seasonal flu infection. This cap-dependent endonuclease inhibitor is a prodrug that releases the biologically active baloxavir acid. This new medicine has been marketed in Japan, the USA and Europe. It is well tolerated (more than 1% of the patients experienced diarrhea, bronchitis, nausea, nasopharyngitis, and headache), and both influenza A and B viruses are sensitive, although the B strain is more resistant due to variations in the amino acid residues in the binding site. The drug is now in post-marketing pharmacovigilance phase, and its interest will be especially re-evaluated in the future during the annual flu outbreaks. It has been also introduced in a recent clinical trial against COVID-19 with favipiravir.

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

Cited by 45 publications

References 78 publications

Clinical Pathway for Influenza in the Elderly: A comprehensive management protocol of Malaysia

Clinical Pathway for Influenza in the Elderly: A comprehensive management protocol of Malaysia

Saisonale Influenza – Aktuelles zu Epidemiologie, Prävention und Therapie

Baloxavir Marboxil: An Original New Drug against Influenza

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