Factors associated with non-persistence to oral and inhaled antiviral therapies for seasonal influenza: a secondary analysis of a double-blind, multicentre, randomised clinical trial.
BMJ Open
; 7(7): e014546, 2017 Jul 10.
Article
en En
| MEDLINE
| ID: mdl-28698321
ABSTRACT
OBJECTIVES:
We aimed to evaluate and compare non-adherence to oral and inhaled antiviral therapies prescribed of a randomised clinical trial in outpatients with influenza A infection.DESIGN:
A parallel, three-arm, double-blinded trial randomly allocated antiviral therapies twice daily for 5 days (1) oral oseltamivir plus inhaled zanamivir (arm OZ); (2) oseltamivir plus inhaled placebo (arm Opz); or (3) oral placebo plus inhaled zanamivir (arm poZ). Analysis of non-adherence was a secondary objective of the trial. SETTINGS Outpatients were enrolled by 145 general practitioners throughout France during the 2008-2009 seasonal influenza epidemics.PARTICIPANTS:
A total of 541 adults presenting with influenza-like illness for less than 36 hours. PRIMARYOUTCOMES:
Non-persistence, the time between inclusion and the last dose treated as a failure time, was used as the primary endpoint.RESULTS:
The proportions of patients who persisted on treatment until the end of prescription were estimated at 85.73% (±3.28%) for the oral route and 82.73% (±3.44%) for the inhaled route. Based on multivariable models, non-persistence was associated with a PCR confirmation of influenza for both the oral (HR=0.54, p=0.010) and inhaled (HR=0.59, p=0.018) drugs and antibiotic coprescriptions (HR=2.07, p=0.007; and HR=1.88, p=0.017, respectively) and active combination treatment (HR=1.71, p=0.035; and HR=1.58, p=0.035, respectively). The hazard of non-persistence of the inhaled therapy was increased compared with that of the oral therapy (HR=1.23, p=0.043).CONCLUSION:
In addition to the clinical and virological profiles of influenza infection, non-persistence may have been influenced by an active combination and the route of administration. RCT REGISTRATION NUMBER NCT00799760. This is a post-result analysis.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Antivirales
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Gripe Humana
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Oseltamivir
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Zanamivir
Tipo de estudio:
Clinical_trials
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
País como asunto:
Europa
Idioma:
En
Año:
2017
Tipo del documento:
Article