Impact of neuraminidase inhibitor treatment on outcomes of public health importance during the 2009-2010 influenza A(H1N1) pandemic: a systematic review and meta-analysis in hospitalized patients.

Stella G. Muthuri*, Puja R. Myles, Sudhir Venkatesan, J. Leonardi-Bee, Jonathan Nguyen-van-Tam

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

135 Citations (Scopus)

Abstract

The impact of neuraminidase inhibitor (NAI) treatment on clinical outcomes of public health importance during the 2009-2010 pandemic has not been firmly established. We conducted a systematic review and meta-analysis, searching 11 databases (2009 through April 2012) for relevant studies. We used standard methods conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using random effects models. Regarding mortality we observed a nonsignificant reduction associated with NAI treatment (at any time) versus none (OR, 0.72 [95% CI, .51-1.01]). However we observed significant reductions for early treatment (≤48 hours after symptom onset) versus late (OR, 0.38 [95% CI, .27-.53]) and for early treatment versus none (OR, 0.35 [95% CI, .18-.71]). NAI treatment (at any time) versus none was associated with an elevated risk of severe outcome (OR, 1.76 [95% CI, 1.22-2.54]), but early versus late treatment reduced the likelihood (OR, 0.41 [95% CI, .30-.56]). During the 2009-2010 influenza A(H1N1) pandemic, early initiation of NAI treatment reduced the likelihood of severe outcomes compared with late or no treatment. PROSPERO REGISTRATION: CRD42011001273.

Original languageEnglish
Pages (from-to)553-563
Number of pages11
JournalUnknown Journal
Volume207
Issue number4
DOIs
Publication statusPublished - 15 Feb 2013

Bibliographical note

Funding Information:
Financial support. This work was funded via an unrestricted grant from F. Hoffmann–La Roche. Details of the contract may be examined freely at http://www.nottingham.ac.uk/chs/research/projects/pride/index. aspx.

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