Tags

Type your tag names separated by a space and hit enter

Safety and effectiveness of neuraminidase inhibitors for influenza treatment, prophylaxis, and outbreak control: a systematic review of systematic reviews and/or meta-analyses.
J Antimicrob Chemother. 2017 Nov 01; 72(11):2990-3007.JA

Abstract

Objectives

To review evidence from systematic reviews and/or meta-analyses (SR/MAs) regarding neuraminidase inhibitor (NI) safety and effectiveness.

Methods

We conducted an SR of SR/MAs of randomized control and/or observational studies. We searched eight electronic databases for SR/MAs that examined the effectiveness or safety of NIs administered for influenza (i.e. influenza-like illness or lab-confirmed) treatment or prophylaxis.

Results

We identified 27 (0.7%) eligible SR/MAs of 3723 articles reviewed. NI (n = 2) or oseltamivir (n = 1) versus no treatment were consistently associated with a decrease in mortality odds among the hospitalized, general population (OR range 0.2 - 0.8). Oseltamivir versus no treatment was associated with a decrease in hospitalization and pneumonia risk/odds in 2/4 SR/MAs. Oseltamivir (n = 4) and zanamivir (n = 3) were consistently associated with a 0.5 - 1 day decrease in symptom duration. Oseltamivir (n = 4) or zanamivir (n = 4) versus no prophylaxis were consistently associated with a decrease in the odds/risk of symptomatic secondary transmission (OR/RR range 0.1 - 0.5). Oseltamivir versus no treatment was consistently associated with a 1.5- to 2.5-fold increase in the odds/risk of nausea (n = 4) and vomiting (n = 5).

Conclusions

NI treatment is likely to be effective at reducing mortality among hospitalized patients, and symptom duration by up to 1 day in the general population. Oseltamivir or zanamivir prophylaxis are likely to be effective at reducing secondary symptomatic influenza transmission. Increased nausea and vomiting are likely associated with oseltamivir use. We recommend that decisions regarding NI use are made in consideration of potential adverse events, particularly for the general population at low risk of complications. Among hospitalized patients, NI administration seems warranted to reduce mortality risk.

Authors+Show Affiliations

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada.Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, QC, Canada. Infection Control and Prevention Unit, Division of Pediatric Infectious Diseases and Medical Microbiology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28961794

Citation

Doll, M K., et al. "Safety and Effectiveness of Neuraminidase Inhibitors for Influenza Treatment, Prophylaxis, and Outbreak Control: a Systematic Review of Systematic Reviews And/or Meta-analyses." The Journal of Antimicrobial Chemotherapy, vol. 72, no. 11, 2017, pp. 2990-3007.
Doll MK, Winters N, Boikos C, et al. Safety and effectiveness of neuraminidase inhibitors for influenza treatment, prophylaxis, and outbreak control: a systematic review of systematic reviews and/or meta-analyses. J Antimicrob Chemother. 2017;72(11):2990-3007.
Doll, M. K., Winters, N., Boikos, C., Kraicer-Melamed, H., Gore, G., & Quach, C. (2017). Safety and effectiveness of neuraminidase inhibitors for influenza treatment, prophylaxis, and outbreak control: a systematic review of systematic reviews and/or meta-analyses. The Journal of Antimicrobial Chemotherapy, 72(11), 2990-3007. https://doi.org/10.1093/jac/dkx271
Doll MK, et al. Safety and Effectiveness of Neuraminidase Inhibitors for Influenza Treatment, Prophylaxis, and Outbreak Control: a Systematic Review of Systematic Reviews And/or Meta-analyses. J Antimicrob Chemother. 2017 Nov 1;72(11):2990-3007. PubMed PMID: 28961794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety and effectiveness of neuraminidase inhibitors for influenza treatment, prophylaxis, and outbreak control: a systematic review of systematic reviews and/or meta-analyses. AU - Doll,M K, AU - Winters,N, AU - Boikos,C, AU - Kraicer-Melamed,H, AU - Gore,G, AU - Quach,C, PY - 2017/03/08/received PY - 2017/07/07/accepted PY - 2017/9/30/pubmed PY - 2018/6/15/medline PY - 2017/9/30/entrez SP - 2990 EP - 3007 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 72 IS - 11 N2 - Objectives: To review evidence from systematic reviews and/or meta-analyses (SR/MAs) regarding neuraminidase inhibitor (NI) safety and effectiveness. Methods: We conducted an SR of SR/MAs of randomized control and/or observational studies. We searched eight electronic databases for SR/MAs that examined the effectiveness or safety of NIs administered for influenza (i.e. influenza-like illness or lab-confirmed) treatment or prophylaxis. Results: We identified 27 (0.7%) eligible SR/MAs of 3723 articles reviewed. NI (n = 2) or oseltamivir (n = 1) versus no treatment were consistently associated with a decrease in mortality odds among the hospitalized, general population (OR range 0.2 - 0.8). Oseltamivir versus no treatment was associated with a decrease in hospitalization and pneumonia risk/odds in 2/4 SR/MAs. Oseltamivir (n = 4) and zanamivir (n = 3) were consistently associated with a 0.5 - 1 day decrease in symptom duration. Oseltamivir (n = 4) or zanamivir (n = 4) versus no prophylaxis were consistently associated with a decrease in the odds/risk of symptomatic secondary transmission (OR/RR range 0.1 - 0.5). Oseltamivir versus no treatment was consistently associated with a 1.5- to 2.5-fold increase in the odds/risk of nausea (n = 4) and vomiting (n = 5). Conclusions: NI treatment is likely to be effective at reducing mortality among hospitalized patients, and symptom duration by up to 1 day in the general population. Oseltamivir or zanamivir prophylaxis are likely to be effective at reducing secondary symptomatic influenza transmission. Increased nausea and vomiting are likely associated with oseltamivir use. We recommend that decisions regarding NI use are made in consideration of potential adverse events, particularly for the general population at low risk of complications. Among hospitalized patients, NI administration seems warranted to reduce mortality risk. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/28961794/Safety_and_effectiveness_of_neuraminidase_inhibitors_for_influenza_treatment_prophylaxis_and_outbreak_control:_a_systematic_review_of_systematic_reviews_and/or_meta_analyses_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkx271 DB - PRIME DP - Unbound Medicine ER -