Characteristics and mortality of severe influenza cases treated with parenteral aqueous zanamivir, United Kingdom, October 2009 to January 2011

Paul Cleary*, Jonathan Crofts, Frances Parry-Ford, Meera Chand-Kumar, Nicholas Phin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Aqueous zanamivir solution, an investigational product, was provided by the manufacturer on compassionate grounds for parenteral administration to severe H1N1pdm09 influenza cases during the 2009 pandemic. Objective: To describe characteristics and outcomes of UK patients receiving parenteral zanamivir therapy. Methods: Collaborators at multiple hospital sites gathered retrospective data on patients receiving aqueous zanamivir therapy between Q4 2009 and Q1 2011. We present analysis of the demographics, clinical features, treatment and outcomes of this cohort. Results: Data on 185 cases were obtained (response rate of 38%; median age 43 years; 62% male; 17% non-Caucasian ethnic group). Most frequent co-morbidities included cancer, immunosuppression and respiratory conditions. Most patients received intravenous zanamivir alone (90%), for durations of up to 21 days. 13% of cases had adverse effects related to zanamivir therapy. Thirty four percentage of cases died. No significant relationship was seen between mortality and timing or route of administration of aqueous zanamivir therapy. Conclusions: The response rate of this observational study of the outcomes of treatment of severe influenza was low, allowing limited conclusions to be drawn. Some potential adverse effects were noted. Clinicians should carefully consider potential risks and benefits of use of this product. New treatment options are urgently required to improve outcomes for patients with severe influenza infections.

Original languageEnglish
Pages (from-to)44-53
Number of pages10
JournalInfluenza and other Respiratory Viruses
Volume13
Issue number1
DOIs
Publication statusPublished - Jan 2019

Bibliographical note

Funding Information:
The study was funded by an unrestricted grant from GlaxoSmithKline. The funder received data and interim reports from Public Health England for information but did not influence analysis and reporting of the study. The authors wish to acknowledge the support of the Intensive Care Society for this study and to thank all colleagues who contributed data: Barts Health NHS Trust (Dr Raj Ashok), Blackpool Teaching Hospitals NHS Foundation Trust (Sister Emma Brennan), Central Manchester University Hospitals NHS Foundation Trust (Ms Alison Royle), City Hospitals Sunderland NHS Foundation Trust (Dr John Green), Colchester Hospital University NHS Foundation Trust (Dr Andrew Timmins), East Lancashire Hospitals NHS Trust (Dr S Gilligan), Gloucestershire Hospitals NHS Foundation Trust (Dr Haslam Mark and Dr Ian Crabb), Great Ormond Street Hospital for Children NHS Foundation Trust (Ms Amy Jones), Great Western Hospitals NHS Foundation Trust (Dr Rachel Prout), Guy's and St Thomas? NHS Foundation Trust (Dr Marlies Ostermann), Hampshire Hospitals NHS Foundation Trust (Dr Stephen Wimbush), Imperial College Healthcare NHS Trust (Dr. Roseanne Meacher, Dr Stephen Brett and Dr. Martin Stotz), Lancashire Teaching Hospitals NHS Foundation Trust (Dr H Twamley), Nottingham University Hospitals NHS Trust (Dr Martin Beed), Plymouth Hospitals NHS Trust (Dr Colin Ferguson), Poole Hospital NHS Trust (Dr Spike Briggs), Sheffield Teaching Hospitals NHS Foundation Trust (Dr Daniele Bryden), South Devon Healthcare NHS Foundation Trust (Dr Michael Mercer), South Warwickshire NHS Foundation Trust (Dr Murali Raghavan), Taunton and Somerset NHS Foundation Trust (Dr Stephen Harris), The Christie NHS Foundation Trust (Dr Vidya Kasipandian), The Newcastle upon Tyne Hospitals NHS Foundation Trust (Dr Stephen Wright), The Royal Wolverhampton NHS Trust (Ms Stella Metherell), University College London Hospitals NHS Foundation Trust (Dr Eleni Nastouli), University Hospital Southampton NHS Foundation Trust (Ms Kim Golder), University Hospitals Bristol NHS Foundation Trust (Dr Bewley), University Hospitals Of Leicester NHS Trust (Dr Gary Lau), York Teaching Hospital NHS Foundation Trust (Dr Simon Dyer), Belfast Health and Social Care Trust (Dr Danny McAuley and Ms Griania White), The Northern Health and Social Care Trust (Dr Christopher Nutt and Ms Orla O'Neil), The Western Health and Social Care Trust (Ms Sinead O'Kane), NHS Ayrshire and Arran (Dr Gordon Houston), NHS Lanarkshire (Dr Veronica Watsion), Aneurin Bevan Health Board (Dr Nick Mason), Cardiff and Vale University Health Board (Dr Matt Wise) and Cwm Taf Health Board (Dr Tamas Szakmany).

Funding Information:
The study was funded by an unrestricted grant from GlaxoSmithKline. The funder received data and interim reports from Public Health England for information but did not influence analysis and reporting of the study.

Publisher Copyright:
© 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Keywords

  • H1N1
  • critical care outcomes
  • influenza
  • pandemic
  • zanamivir

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