期刊
EXPERT REVIEW OF CLINICAL PHARMACOLOGY
卷 14, 期 7, 页码 901-918出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/17512433.2021.1917378
关键词
Baloxavir marboxil; influenza; neuraminidase inhibitors; oseltamivir; peramivir; zanamivir
资金
- CIBERES, Instituto de Salud Carlos III, Madrid, Spain (Fondos FEDER) [CB06-06-036]
The study found that baloxavir and neuraminidase inhibitors (NAIs) have a significant reduction effect on complications of uncomplicated influenza, especially in reducing antibiotic prescriptions. Single-dose baloxavir is non-inferior to NAIs in terms of safety and efficacy.
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 (OR:0.55, 95%CI: 0.42-0.73). Specifically, antivirals significantly decreased bronchitis (OR:0.54, 95%CI: 0.38-0.75), sinusitis (OR:0.51, 95%CI: 0.33-0.78), acute otitis media (OR:0.48, 95%CI: 0.30-0.77), and antibiotic prescription (OR:0.62; 95%CI: 0.48-0.80). A positive trend favored antivirals administration to reduce pneumonia (OR:0.47, 95%CI: 0.16-1.33), or hospitalization rates (OR:0.65; 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 (OR:0.74, 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.
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