Kate R Beard1, Nathan J Brendish1,2, Tristan W Clark1,2,3,4. 1. Academic Unit of Clinical and Experimental Sciences, University of Southampton. 2. Department of Infection. 3. NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust. 4. NIHR Post-Doctoral Fellowship Programme.
Abstract
PURPOSE OF REVIEW: Seasonal and pandemic influenza are major causes of morbidity and mortality globally. Neuraminidase inhibitors (NAIs) are the only class of antiviral agent recommended for the treatment of currently circulating strains of influenza. There has previously been controversy over the level of evidence for patient benefit with NAIs. We review here the current evidence base for the clinical impact of treatment of influenza with NAIs. RECENT FINDINGS: Meta-analysis of pharma-sponsored studies (including previously unpublished data) shows that NAIs reduce the duration of illness in influenza-infected patients, and suggest a possible reduction in the rate of complications and hospitalization. Meta-analysis of observational studies examining oseltamivir use during the H1N1 2009 pandemic, suggest a reduction in hospitalization rate in community-dwelling patients and a reduction in mortality in hospitalized adults treated with NAIs. Current NAI use in the community and hospitals varies widely but in general they are underutilized. SUMMARY: Although there has been controversy over the level of evidence for patient benefit, a growing body of evidence suggests that treatment of influenza with NAIs is associated with improved outcomes for both patients in the community and more severely unwell patients in hospital. Clinical outcomes are optimal with earlier use and strategies to improve early widespread NAI utilization are needed.
PURPOSE OF REVIEW: Seasonal and pandemic influenza are major causes of morbidity and mortality globally. Neuraminidase inhibitors (NAIs) are the only class of antiviral agent recommended for the treatment of currently circulating strains of influenza. There has previously been controversy over the level of evidence for patient benefit with NAIs. We review here the current evidence base for the clinical impact of treatment of influenza with NAIs. RECENT FINDINGS: Meta-analysis of pharma-sponsored studies (including previously unpublished data) shows that NAIs reduce the duration of illness in influenza-infectedpatients, and suggest a possible reduction in the rate of complications and hospitalization. Meta-analysis of observational studies examining oseltamivir use during the H1N1 2009 pandemic, suggest a reduction in hospitalization rate in community-dwelling patients and a reduction in mortality in hospitalized adults treated with NAIs. Current NAI use in the community and hospitals varies widely but in general they are underutilized. SUMMARY: Although there has been controversy over the level of evidence for patient benefit, a growing body of evidence suggests that treatment of influenza with NAIs is associated with improved outcomes for both patients in the community and more severely unwell patients in hospital. Clinical outcomes are optimal with earlier use and strategies to improve early widespread NAI utilization are needed.
Authors: Ju Hwan Jeong; Won-Suk Choi; Khristine Joy C Antigua; Young Ki Choi; Elena A Govorkova; Richard J Webby; Yun Hee Baek; Min-Suk Song Journal: J Virol Date: 2020-12-09 Impact factor: 5.103
Authors: Iuliia M Gilchuk; Sandhya Bangaru; Pavlo Gilchuk; Ryan P Irving; Nurgun Kose; Robin G Bombardi; Natalie J Thornburg; C Buddy Creech; Kathryn M Edwards; Sheng Li; Hannah L Turner; Wenli Yu; Xueyong Zhu; Ian A Wilson; Andrew B Ward; James E Crowe Journal: Cell Host Microbe Date: 2019-11-19 Impact factor: 31.316