Please use this identifier to cite or link to this item: https://doi.org/10.1111/irv.12363
Title: Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis
Authors: Muthuri, S.G
Venkatesan, S
Myles, P.R
Keywords: sialidase inhibitor
antiinfective agent
antivirus agent
corticosteroid
enzyme inhibitor
sialidase
adolescent
adult
adult respiratory distress syndrome
age distribution
Article
disease association
disease severity
female
human
incidence
infection risk
influenza A (H1N1)
intensive care
interactive ventilatory support
major clinical study
male
meta analysis
mortality rate
pneumonia
priority journal
sex difference
time to treatment
treatment outcome
antagonists and inhibitors
child
diagnostic imaging
drug effects
enzymology
Influenza A virus (H1N1)
Influenza, Human
middle aged
mortality
odds ratio
Pneumonia, Viral
preschool child
virology
young adult
Adolescent
Adrenal Cortex Hormones
Adult
Anti-Bacterial Agents
Antiviral Agents
Child
Child, Preschool
Enzyme Inhibitors
Female
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human
Male
Middle Aged
Neuraminidase
Odds Ratio
Pneumonia, Viral
Treatment Outcome
Young Adult
Issue Date: 2016
Citation: Muthuri, S.G, Venkatesan, S, Myles, P.R (2016). Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis. Influenza and other Respiratory Viruses 10 (3) : 192-204. ScholarBank@NUS Repository. https://doi.org/10.1111/irv.12363
Rights: Attribution 4.0 International
Abstract: 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. © 2016 John Wiley & Sons Ltd..
Source Title: Influenza and other Respiratory Viruses
URI: https://scholarbank.nus.edu.sg/handle/10635/179929
ISSN: 17502640
DOI: 10.1111/irv.12363
Rights: Attribution 4.0 International
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