Neuraminidase inhibitors and single dose baloxavir are effective and safe in uncomplicated influenza: a meta-analysis of randomized controlled trials.
Expert Rev Clin Pharmacol
; 14(7): 901-918, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-33861168
ABSTRACT
BACKGROUND:
Scarce evidence verifying the clinical impact of baloxavir on influenza complications is found.METHODS:
PubMed, Cochrane Library, and Web of Science databases were searched through December 2020. Randomized-controlled trials (RCT) that enrolled patients with laboratory-confirmed influenza receiving neuraminidase inhibitors (NAI) or baloxavir comparing to placebo were assessed. PROSPERO Registration-number CRD42021226854.RESULTS:
Twenty-one RCTs (11,697 patients) were included. Antiviral administration significantly reduced time to clinical resolution (mean difference -21.3 hours) and total influenza-related complications (OR0.55, 95%CI 0.42-0.73). Specifically, antivirals significantly decreased bronchitis (OR0.54, 95%CI 0.38-0.75), sinusitis (OR0.51, 95%CI 0.33-0.78), acute otitis media (OR0.48, 95%CI 0.30-0.77), and antibiotic prescription (OR0.62; 95%CI 0.48-0.80). A positive trend favored antivirals administration to reduce pneumonia (OR0.47, 95%CI 0.16-1.33), or hospitalization rates (OR0.65; 95%CI 0.34-1.24) compared to placebo, but did not reach statistical significance. Adverse events (AE) were reported in 11%, 8.9%, and 5.1% of NAIs, placebo and baloxavir recipients, respectively. Compared with NAIs, administration of baloxavir showed non-significantly reduced AEs (OR0.74, 95%CI 0.53-1.04).CONCLUSIONS:
Single-dose baloxavir and NAIs were superior to placebo to reduce complications in uncomplicated influenza, with 40% significant reduction in antibiotic prescription. Safety and efficacy of single-dose baloxavir were non-inferior to NAIs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Piridonas
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Triazinas
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Morfolinas
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Dibenzotiepinas
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Influenza Humana
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Neuraminidase
Tipo de estudo:
Clinical_trials
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Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Expert Rev Clin Pharmacol
Ano de publicação:
2021
Tipo de documento:
Article