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Impact of Neuraminidase Inhibitors on Influenza A(H1n1)Pdm09-Related Pneumonia: An Individual Participant Data Meta-Analysis Publisher Pubmed



Muthuri SG1 ; Venkatesan S1 ; Myles PR1 ; Leonardibee J1 ; Lim WS2 ; Al Mamun A3 ; Anovadiya AP4 ; Araujo WN5 ; Azzizbaumgartner E6 ; Baez C7 ; Bantar C8 ; Barhoush MM9 ; Bassetti M10 ; Beovic B11 Show All Authors
Authors
  1. Muthuri SG1
  2. Venkatesan S1
  3. Myles PR1
  4. Leonardibee J1
  5. Lim WS2
  6. Al Mamun A3
  7. Anovadiya AP4
  8. Araujo WN5
  9. Azzizbaumgartner E6
  10. Baez C7
  11. Bantar C8
  12. Barhoush MM9
  13. Bassetti M10
  14. Beovic B11
  15. Bingisser R12
  16. Bonmarin I13
  17. Borjaaburto VH14
  18. Cao B15
  19. Carratala J16
  20. Cuezzo MR17
  21. Denholm JT18
  22. Dominguez SR19
  23. Duarte PAD20
  24. Dubnovraz G21
  25. Echavarria M22
  26. Fanella S23
  27. Fraser J24
  28. Gao Z25
  29. Gerardin P26, 27, 28, 29
  30. Giannella M30
  31. Gubbels S31
  32. Herberg J32
  33. Higuera Iglesias AL33
  34. Hoeger PH34
  35. Hoffmann M35
  36. Hu X36
  37. Islam QT37
  38. Jimenez MF38
  39. Kandeel A39
  40. Keijzers G40
  41. Khalili H41
  42. Khandaker G42
  43. Knight M43
  44. Kusznierz G44
  45. Kuzman I45
  46. Kwan AMC46
  47. Lahlou Amine I47
  48. Langenegger E48
  49. Lankarani KB49
  50. Leo YS50
  51. Linko R51
  52. Liu P52
  53. Madanat F53
  54. Manabe T54
  55. Mayomontero E55
  56. Mcgeer A56
  57. Memish ZA57, 58
  58. Metan G59
  59. Mikic D60
  60. Mohn KGI61, 62
  61. Moradi A63, 64
  62. Nymadawa P65
  63. Ozbay B66
  64. Ozkan M67
  65. Parekh D68
  66. Paul M69
  67. Poeppl W70
  68. Polack FP71, 72
  69. Rath BA73
  70. Rodriguez AH74
  71. Siqueira MM75
  72. Skretmagierlo J76
  73. Talarek E77
  74. Tang JW78, 79, 80
  75. Torres A81
  76. Torun SH82
  77. Tran D83
  78. Uyeki TM84
  79. Van Zwol A85
  80. Vaudry W86
  81. Velyvyte D87
  82. Vidmar T88
  83. Zarogoulidis P89
  84. Nguyenvantam JS1

Source: Influenza and other Respiratory Viruses Published:2016


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..
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