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Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis
Influenza and Other Respiratory Viruses
  • Stella G Muthuri, The University of Nottingham
  • Sudhir Venkatesan, The University of Nottingham
  • Puja R Myles, The University of Nottingham
  • Jo Leonardi-Bee, The University of Nottingham
  • Wei Shen Lim, Nottingham University Hospitals NHS Trust
  • Abdullah Al Mamun, Research Bangladesh (ICDDRB)
  • Ashish P Anovadiya, Government Medical College and Sir Takhtsinhji General Hospital
  • Wildo N Araújo, University of Brasília
  • Eduardo Azziz-Baumgartner, Centers for Disease Control and Prevention
  • Clarisa Báez, Ministerio de Salud de la Provincia de Buenos Aires
  • Carlos Bantar, Hospital San Martín de Paraná
  • Mazen M Barhoush, King Saud Medical City
  • Matteo Bassetti, Santa Maria Misericordia Hospital
  • Bojana Beovic, University Medical Centre, Ljubljana
  • Roland Bingisser, University Hospital Basel
  • Isabelle Bonmarin, Institut de Veille Sanitaire
  • Victor H Borja-Aburto, Instituto Mexicano del Seguro Social (IMSS)
  • Bin Cao, Beijing Chao-Yang Hospital,
  • Jordi Carratala, University of Barcelona
  • María R Cuezzo, Ministerio de Salud de Tucumán
  • Justin T Denholm, Peter Doherty Institute for Infection and Immunity
  • Samuel R Dominguez, University of Colorado School of Medicine
  • Pericles A D Duarte, Universidade Estadual do Oeste do Paraná
  • Gal Dubnov-Raz, The Edmond and Lily Safra Children's Hospital
  • Marcela Echavarria, CEMIC University Hospital
  • Sergio Fanella, University of Manitoba
  • James Fraser, Bristol Children's Hospital
  • Zhancheng Gao, Peking University People's Hospital
  • Patrick Gérardin, Hospital General Universitario Gregorio Marañón
  • Maddalena Giannella, Hospital General Universitario Gregorio Marañón
  • Sophie Gubbels, Statens Serum Institut
  • Jethro Herberg, Imperial College London
  • Anjarath L Higuera Iglesias, Instituto Nacional de Enfermedades Respiratorias
  • Peter H Hoeger, Cath. Children's Hospital Wilhelmstift
  • Matthias Hoffmann, Kantonsspital St. Gallen
  • Xiaoyun Hu, Peking Union Medical College Hospital
  • Quazi T Islam, Dhaka Medical College Hospital
  • Mirela F Jiménez, Preceptora da Residência Médica do Hospital Fêmina
  • Amr Kandeel, Ministry of Health in Egypt
  • Gerben Keijzers, Bond University
  • Hossein Khalili
  • Gulam Khandaker
  • Marian Knight
  • Gabriela Kusznierz
  • Ilija Kuzman
  • Arthur M C Kwan
  • Idriss Lahlou Amine
  • Eduard Langenegger
  • Kamran B Lankarani
  • Yee-Sin Leo
  • Rita Linko
  • Pei Liu
  • Faris Madanat
  • Toshie Manabe
  • Elga Mayo-Montero
  • Allison McGeer
  • Ziad A Memish
  • Gokhan Metan
  • Dragan Mikić
  • Kristin G I Mohn
  • Ahmadreza Moradi
  • Pagbajabyn Nymadawa
  • Bulent Ozbay
  • Mehpare Ozkan
  • Dhruv Parekh
  • Mical Paul
  • Wolfgang Poeppl
  • Fernando P Polack
  • Barbara A Rath
  • Alejandro H Rodríguez
  • Marilda M Siqueira
  • Joanna Skręt-Magierło
  • Ewa Talarek
  • Julian W Tang
  • Antoni Torres
  • Selda H Törün
  • Dat Tran
  • Timothy M Uyeki
  • Annelies van Zwol
  • Wendy Vaudry
  • Daiva Velyvyte
  • Tjasa Vidmar
  • Paul Zarogoulidis
  • Jonathan S Nguyen-Van-Tam
Date of this Version
5-1-2016
Document Type
Journal Article
MeSH Headings (Medical Subject Headings)
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Publication Details

Published version

Muthuri, S. G., Venkatesan, S., Myles, P. R., Leonardi-Bee, J., Lim, W. S., Al Mamun, A., ... PRIDE Consortium Investigators (2016). Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis. Influenza and Other Respiratory Viruses, 10(3), 192-204. doi: 10.1111/irv.12363

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© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Distribution License
Creative Commons Attribution 4.0
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.

Citation Information
Stella G Muthuri, Sudhir Venkatesan, Puja R Myles, Jo Leonardi-Bee, et al.. "Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis" Influenza and Other Respiratory Viruses Vol. 10 Iss. 3 (2016) p. 192 - 204 ISSN: 1750-2659
Available at: http://works.bepress.com/gerben_keijzers/37/