Comparison of Efficacy of Intravenous Peramivir and Oral Oseltamivir for the Treatment of Influenza: Systematic Review and Meta-Analysis
| Autor: | Yee Hyung Kim, Ju Hee Park, Jong Hoo Lee, Hyeyoung Jwa |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Oseltamivir medicine.medical_specialty oseltamivir 030106 microbiology Acids Carbocyclic Administration Oral Cyclopentanes Antiviral Agents Guanidines peramivir law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pharmacotherapy Randomized controlled trial Risk Factors law Internal medicine Influenza Human Odds Ratio Humans Medicine human 030212 general & internal medicine Adverse effect Randomized Controlled Trials as Topic fever business.industry General Medicine respiratory Virology Influenza signs and symptoms Clinical trial Infectious Diseases Treatment Outcome chemistry Meta-analysis Original Article Administration Intravenous Observational study Peramivir business Publication Bias medicine.drug |
| Zdroj: | Yonsei Medical Journal |
| ISSN: | 1976-2437 0513-5796 |
| DOI: | 10.3349/ymj.2017.58.4.778 |
| Popis: | Purpose Peramivir is the first intravenously administered neuramidase inhibitor for immediate delivery of an effective single-dose treatment in patients with influenza. However, limited data are available on intravenous (IV) peramivir treatment compared to oral oseltamivir for these patients. Materials and methods With a systematic review and meta-analysis, we compared the efficacy of IV peramivir with oral oseltamivir for treatment of patients with seasonal influenza. MEDLINE, EMBASE, and Cochrane Central Register were searched for relevant clinical trials. Results A total of seven trials [two randomized controlled trials (RCTs) and five non-randomized observational trials] involving 1676 patients were finally analyzed. The total number of peramivir- and oseltamivir-treated patients was 956 and 720, respectively. Overall, the time to alleviation of fever was lower in the peramivir-treated group compared with the oseltamivir-treated group [mean difference (MD), -7.17 hours; 95% confidence interval (CI) -11.00 to -3.34]. Especially, pooled analysis of observational studies (n=4) and studies of outpatients (n=4) demonstrated the superiority of the peramivir-treated group (MD, -7.83 hours; 95% CI -11.81 to -3.84 and MD, -7.71 hours; 95% CI -11.61 to -3.80, respectively). Mortality, length of hospital stay, change in virus titer 48 hours after admission, and the incidence of adverse events in these patients were not significantly different between the two groups. Conclusion IV peramivir therapy might reduce the time to alleviation of fever in comparison with oral oseltamivir therapy in patients with influenza; however, we could not draw clear conclusions from a meta-analysis because of the few RCTs available and methodological limitations. |
| Databáze: | OpenAIRE |
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