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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 |
Appears in Collections: | Staff Publications Elements |
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