tetano
Editor, Senior Moderator
Yonsei Med J. 2017 Jul;58(4):778-785. doi: 10.3349/ymj.2017.58.4.778.
[h=1]Comparison of Efficacy of Intravenous Peramivir and Oral Oseltamivir for the Treatment of Influenza: Systematic Review and Meta-Analysis.[/h] Lee J[SUP]1[/SUP], Park JH[SUP]2[/SUP], Jwa H[SUP]1[/SUP], Kim YH[SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]PURPOSE:[/h] 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.
[h=4]MATERIALS AND METHODS:[/h] 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.
[h=4]RESULTS:[/h] 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.
[h=4]CONCLUSION:[/h] 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.
[h=4]KEYWORDS:[/h] Influenza; fever; human; oseltamivir; peramivir; respiratory; signs and symptoms
PMID: 28540991 DOI: 10.3349/ymj.2017.58.4.778
[h=1]Comparison of Efficacy of Intravenous Peramivir and Oral Oseltamivir for the Treatment of Influenza: Systematic Review and Meta-Analysis.[/h] Lee J[SUP]1[/SUP], Park JH[SUP]2[/SUP], Jwa H[SUP]1[/SUP], Kim YH[SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]PURPOSE:[/h] 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.
[h=4]MATERIALS AND METHODS:[/h] 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.
[h=4]RESULTS:[/h] 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.
[h=4]CONCLUSION:[/h] 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.
[h=4]KEYWORDS:[/h] Influenza; fever; human; oseltamivir; peramivir; respiratory; signs and symptoms
PMID: 28540991 DOI: 10.3349/ymj.2017.58.4.778