Oral oseltamivir reduces febrile illness in patients considered at high risk of influenza complications

Martín, Carina Aguilar; Mahoney, Paul; Ward, Penelope

doi:10.1016/s0531-5131(01)00359-4

Cited by 13 publications

(20 citation statements)

References 3 publications

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“…An approximately 13% incidence of influenza-associated complications has been reported among patients treated with zanamivir (18). As the present trial had no control group, accurate evaluation of the magnitude of the incidence was difficult, but rates of influenza-associated complications as a whole and of pneumonia were 10.8% and 8.1%, respectively.…”

Section: Discussionmentioning

confidence: 68%

“…An open study of Chinese subjects found a significant difference in the median duration of influenza illness between oseltamivir (110 h) and placebo (174 h; P ϭ 0.0479) (16), while a study of febrile patients found that the median duration of illness on the basis of principal symptoms (e.g., fever) was shorter with oseltamivir (40.8 h) than with placebo (57.9 h; P ϭ 0.0005) (18). Another report found a significantly reduced duration of influenza illness, from 7.0 days with placebo to 5.5 days (P ϭ 0.009) with oseltamivir, among influenza-positive patients Ն12 years old who had asthma or chronic obstructive pulmonary disease as a complication (26).…”

Section: Discussionmentioning

confidence: 95%

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Intravenous Peramivir for Treatment of Influenza A and B Virus Infection in High-Risk Patients

Kohno

Kida

Mizuguchi

et al. 2011

Antimicrob Agents Chemother

110

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Influenza virus infections are known to persist longer in patients with underlying diseases, including respiratory tract diseases, and tend to become complicated by secondary influenza-associated infections, such as pneumonia. To assess the efficacy and safety of the novel anti-influenza virus drug peramivir in high-risk patients, we conducted a clinical trial of patients with diabetes or chronic respiratory tract diseases and patients being treated with drugs that suppress immune function. In this multicenter, uncontrolled, randomized, double-blind study, peramivir was intravenously administered at 300 or 600 mg/day for 1 to 5 days, as needed. Efficacy was investigated in 37 patients (300 mg, n ‫؍‬ 18 patients; 600 mg, n ‫؍‬ 19 patients). The median durations of influenza illness were 68.6 h (90% confidence interval, 41.5 to 113.4 h) overall, 114.4 h (90% confidence interval, 40.2 to 235.3 h) in the 300-mg group, and 42.3 h (90% confidence interval, 30.0 to 82.7 h) in the 600-mg group. The hazard ratio for the 600-mg group compared to the 300-mg group was 0.497 (90% confidence interval, 0.251 to 0.984), and the duration of influenza illness was significantly shorter in the 600-mg group than in the 300-mg group. Among the 42 patients in the safety analysis set, adverse events occurred in 73.8% and adverse drug reactions in 33.3%. No adverse events were particularly problematic clinically, and all patients recovered quickly from all events. The measured blood drug concentrations showed no tendency toward accumulation. Drug accumulation with repeated doses was thus considered to be of little concern. Intravenous peramivir appears to offer a potentially useful treatment for high-risk patients in the future.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 95%

Intravenous Peramivir for Treatment of Influenza A and B Virus Infection in High-Risk Patients

Kohno

Kida

Mizuguchi

et al. 2011

Antimicrob Agents Chemother

110

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“…Table 1 displays the trial profiles and shows the proportions of subjects enrolled. [8][9][10][11][12] The enrolled patients included otherwise healthy unimmunized adults and adolescents (age 13-64 years) and a substantial number of at-risk patients, defined as immunized or unimmunized communityliving elderly persons 65 years or older and adults and adolescents with chronic obstructive airways disease, asthma, and/or cardiac disease of sufficient severity to require regular outpatient medical care. Patients with New York Heart Association class IV and American Thoracic Society stage III status were excluded from participation.…”

Section: Methodsmentioning

confidence: 99%

Impact of Oseltamivir Treatment on Influenza-Related Lower Respiratory Tract Complications and Hospitalizations

Kaiser

Wat²,

Mills³

et al. 2003

Arch Intern Med

455

279

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“…Subgroup analysis of a large placebo-controlled study showed that oseltamivir treatment reduced both the rate of lower respiratory tract complications and risk of hospitalization (46). Other studies assessed efficacy in these two risk groups by pooling data from more than one placebo-controlled trial, finding that treatment reduced the duration of acute febrile illness, viral shedding rate, and the rate of respiratory complications (47,48). A randomized study of influenza treatment in 118 adults with chronic heart or lung disease found that oseltamivir was associated with significant reductions in disease severity and duration, as well as in the incidence of complications and antibiotic use, compared with symptomatic treatment alone (49).…”

Section: Other High-risk Populationsmentioning

confidence: 99%

The use of antiviral agents for the management of severe influenza

Smith

Ariano

Toovey

2010

Critical Care Medicine

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The clinical course of pandemic H1N1 2009 influenza can be severe, particularly in the very young and patients with comorbidities. Pandemic H1N1 2009 is sensitive to the antiviral agents oseltamivir and zanamivir but is resistant to the M2 inhibitors. Although few clinical data are yet available, treatment of pandemic H1N1 2009 influenza in hospital settings with oseltamivir or zanamivir appears to be beneficial. In hospitalized patients with severe influenza treated with oseltamivir, mortality and length of stay are significantly reduced, and viral load is reduced more quickly than in untreated patients. In patients at high risk treated with oseltamivir or zanamivir, reductions in the risk of complications and mortality after treatment have been demonstrated with oseltamivir and zanamivir, although there are fewer data on the latter. There is no evidence yet that other antiviral agents are effective in severe or pandemic H1N1 2009 influenza. Current World Health Organization guidance strongly recommends the use of oseltamivir for severe or progressive infection with pandemic H1N1 2009, with zanamivir as an alternative if the infecting virus is oseltamivir-resistant. Very little resistance to oseltamivir has been found to date.

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Oral oseltamivir reduces febrile illness in patients considered at high risk of influenza complications

Cited by 13 publications

References 3 publications

Intravenous Peramivir for Treatment of Influenza A and B Virus Infection in High-Risk Patients

Intravenous Peramivir for Treatment of Influenza A and B Virus Infection in High-Risk Patients

Impact of Oseltamivir Treatment on Influenza-Related Lower Respiratory Tract Complications and Hospitalizations

The use of antiviral agents for the management of severe influenza

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