Antivirals for influenza: a summary of a systematic review and meta‐analysis of observational studies

Influenza and Other Respiratory Viruses

Nancy Santesso³  Jonathan Hsu³  Reem Mustafa³  Jan Brozek³  Yao Long Chen⁷  Jessica P. Hopkins³  Adrienne Cheung³  Gayane Hovhannisyan³  Liudmila Ivanova³  Signe A. Flottorp⁴  Ingvil Sæterdal⁴  Arthur D. Wong¹  Jinhui Tian⁷  Timothy M. Uyeki⁶  Elie A. Akl³  Pablo Alonso-Coello²  Fiona Smaill⁵ 

[1] Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada;Iberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain;Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada;Norwegian Knowledge Centre for the Health Services, Oslo, Norway;Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada;Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA;Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Gansu, China

关键词: antiviral;    influenza;    M2 ion channel blocker;    neuraminidase inhibitor;    observational study;   

DOI  :  10.1111/irv.12085

来源: Wiley

【 摘 要 】

Abstract

Despite the use of antivirals to treat patients with severe influenza, questions remain with respect to effects and safety. Although a recent systematic review has provided some indication of benefit, the analysis is limited by the quality of the available evidence from randomized controlled trials. To supplement the existing information, the authors conducted a systematic review of observational studies of antiviral treatment for influenza. This report summarises the findings of that review. Similar to the randomised trials, the confidence in the estimates of the effects for decision-making is low to very low primarily due to the risk of selection and publication bias in the observational studies. From these observational studies, the summary estimates suggest that oseltamivir may reduce mortality, hospitalisation and duration of symptoms compared with no treatment. Inhaled zanamivir may also reduce symptom duration and hospitalisations, but patients may experience more complications compared with no treatment. Earlier treatment with antivirals is generally associated with better outcomes than later treatment. Further high-quality evidence is needed to inform treatment guidelines because of the overall low to very low quality of evidence.

【 授权许可】

Unknown   
© 2013 Blackwell Publishing Ltd