Effect of a Single Inhalation of Laninamivir Octanoate in Children With Influenza

Abstract

OBJECTIVE: The purpose of this study was to compare the efficiency and safety of a new neuraminidase inhibitor, laninamivir octanoate (LO), with zanamivir (ZN) in pediatric patients with influenza. METHODS: One hundred twelve pediatric patients ≤15 years, diagnosed with a rapid diagnostic test as having influenza from January to May 2011, were randomly assigned to the LO group or the ZN group, and their parents were asked to complete a questionnaire during the recovery at home. The LO group was instructed to inhale LO once (20 or 40 mg depending on age), and the ZN group was instructed to inhale ZN (20 mg) twice daily for 5 days. RESULTS: The LO group (n = 55) and the ZN group (n = 57) were well balanced. Finally, 44 patients in the LO group and 41 patients in the ZN group could be evaluated. Median times to fever resolution after initial treatment were 36 hours in the LO group and 37 hours in the ZN group. No differences were observed between the 2 groups with respect to the frequencies of asthmatic symptoms, pneumonia, gastrointestinal symptoms, or abnormal behaviors. Six younger children could not inhale LO well for technical reasons. CONCLUSIONS: Our data suggest that the efficiency and safety of LO are the same as those of ZN in pediatric patients with influenza but that LO may be more convenient than ZN because it requires only a single inhalation. However, younger patients may not inhale LO efficiently.

Comparison of the clinical effectiveness of zanamivir and laninamivir octanoate for children with influenza A(H3N2) and B in the 2011–2012 season

“…There was no significant difference in the time to alleviation of influenza A(H3N2) or B virus infection between patients treated with LO and OT . Comparisons of the clinical effectiveness of ZN and LO have been limited . In this study, we evaluated the clinical effectiveness of the two inhaled NAIs (ZN and LO) for influenza A(H3N2) and B virus infections by comparing the durations of fever after administration of the first doses of NAIs.…”

Antiviral Treatments

“…25,26 Laninamivir shows a similar duration of fever in ambulatory children compared with patients treated with zanamivir. 27,28 Among household contacts of an index patient with influenza, 2 and 3 days of laninamivir 20 mg daily was associated with a 77% and 78% protective efficacy, respectively, compared with placebo. 29 Common side effects include nausea, vomiting, diarrhea, and dizziness.…”

Incomplete Inhalation of Laninamivir Octanoate in Children with Influenza

“…The questionnaire asked about symptoms before and after drug administration, including the time to fever resolution and asthmatic symptoms. We defined the time until the beginning of the first 12-hour period in which the temperature returned to less than 37.5°C without recent acetaminophen as time to fever resolution and coughing and wheezing as asthmatic symptoms, same as in previous study [2]. Parents were instructed to mail the completed questionnaire to our hospital «after the patient was completely cured».…”

“…A single inhalation of LO was estimated to be as effective as repeated doses of OT [1]. LO was also found to be as effective as ZN, although younger children had some difficulty with inhaling [2]. However, children with asthma who inhale steroids everyday had little difficulty with inhaling LO.…”