학술논문
Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis
Document Type
Academic Journal
Author
Muthuri, Stella G.; Venkatesan, Sudhir; Myles, Puja R.; Leonardi‐Bee, Jo; Lim, Wei Shen; Mamun, Abdullah Al; Anovadiya, Ashish P.; Araújo, Wildo N.; Azziz‐Baumgartner, Eduardo; Báez, Clarisa; Bantar, Carlos; Barhoush, Mazen M.; Bassetti, Matteo; Beovic, Bojana; Bingisser, Roland; Bonmarin, Isabelle; Borja‐Aburto, Victor H.; Cao, Bin; Carratala, Jordi; Cuezzo, María R.; Denholm, Justin T.; Dominguez, Samuel R.; Duarte, Pericles A.D.; Dubnov‐Raz, Gal; Echavarria, Marcela; Fanella, Sergio; Fraser, James; Gao, Zhancheng; Gérardin, Patrick; Giannella, Maddalena; Gubbels, Sophie; Herberg, Jethro; Iglesias, Anjarath L. Higuera; Hoeger, Peter H.; Hoffmann, Matthias; Hu, Xiaoyun; Islam, Quazi T.; Jiménez, Mirela F.; Kandeel, Amr; Keijzers, Gerben; Khalili, Hossein; Khandaker, Gulam; Knight, Marian; Kusznierz, Gabriela; Kuzman, Ilija; Kwan, Arthur M.C.; Amine, Idriss Lahlou; Langenegger, Eduard; Lankarani, Kamran B.; Leo, Yee‐Sin; Linko, Rita; Liu, Pei; Madanat, Faris; Manabe, Toshie; Mayo‐Montero, Elga; Mcgeer, Allison; Memish, Ziad A.; Metan, Gokhan; Mikić, Dragan; Mohn, Kristin G.I.; Moradi, Ahmadreza; Nymadawa, Pagbajabyn; Ozbay, Bulent; Ozkan, Mehpare; Parekh, Dhruv; Paul, Mical; Poeppl, Wolfgang; Polack, Fernando P.; Rath, Barbara A.; Rodríguez, Alejandro H.; Siqueira, Marilda M.; Skręt‐Magierło, Joanna; Talarek, Ewa; Tang, Julian W.; Torres, Antoni; Törün, Selda H.; Tran, Dat; Uyeki, Timothy M.; Zwol, Annelies; Vaudry, Wendy; Velyvyte, Daiva; Vidmar, Tjasa; Zarogoulidis, Paul; Nguyen‐Van‐Tam, Jonathan S.; Aguiar‐Oliveira, Maria Lourdes; Khuwaitir, Tarig Sa Al; Masri, Malakita Al; Amin, Robed; Ballester‐Orcal, Elena; Bao, Jing; Basher, Ariful; Bautista, Edgar; Bertisch, Barbara; Bettinger, Julie; Booy, Robert; Bouza, Emilio; Bozkurt, Ilkay; Burgmann, Heinz; Čeljuska‐Tošev, Elvira; Chan, Kenny Kc; Chen, Yusheng; Chinbayar, Tserendorj; Cilloniz, Catia; Cox, Rebecca J.; Sarrouf, Elena B.; Cui, Wei; Dashti‐Khavidaki, Simin; Du, Bin; Rhaffouli, Hicham El; Escobar, Hernan; Florek‐Michalska, Agnieszka; Gerrard, John; Gormley, Stuart; Götberg, Sandra; Honarvar, Behnam; Hu, Jianming; Kemen, Christoph; Koay, Evelyn Sc; Kojic, Miroslav; Kudo, Koichiro; Kyaw, Win M.; Leibovici, Leonard; Li, Xiao‐Li; Li, Hongru; Libster, Romina; Loh, Tze P.; Macbeth, Deborough; Maltezos, Efstratios; Marcone, Débora N.; Marczynska, Magdalena; Mastalir, Fabiane P.; Mickiene, Auksė; Moghadami, Mohsen; Moriconi, Lilian; Oliva, Maria E.; Pečavar, Blaž; Poliquin, Philippe G.; Rahman, Mahmudur; Rascon‐Pacheco, Alberto; Refaey, Samir; Schweiger, Brunhilde; Seale, Anna C.; Sertogullarindan, Bunyamin; Smith, Fang G.; Somer, Ayper; Souza, Thiago Ml; Stephan, Frank; Tabarsi, Payam; Tripathi, Cb; Viasus, Diego; Yu, Qin; Zhang, Wei; Zuo, Wei
Source
Influenza and Other Respiratory Viruses. November 25, 2015, Vol. 10 Issue 3, p192, 13 p.
Subject
Language
English
ISSN
1750-2640
Abstract
Introduction Influenza‐related pneumonia (IRP) was a common and severe complication during the 2009–2010 influenza pandemic. Neuraminidase inhibitors (NAIs), primarily oseltamivir and zanamivir, were widely recommended for patients with suspected or [...]
Background: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. Conclusions: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.
Background: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. Conclusions: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.