Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis

Stella G. Muthuri; Sudhir Venkatesan; Puja R. Myles; Jo Leonardi-Bee; Wei Shen Lim; Abdullah Al Mamun; Ashish P. Anovadiya; Wildo N. Araújo; Eduardo Azziz-Baumgartner; Clarisa Báez; Carlos Bantar; Mazen M. Barhoush; Matteo Bassetti; Bojana Beovic; Roland Bingisser; Isabelle Bonmarin; Victor H. Borja-Aburto; Bin Cao; Jordi Carratala; María R. Cuezzo; Justin T. Denholm; Samuel R. Dominguez; Pericles A.D. Duarte; Gal Dubnov-Raz; Marcela Echavarria; Sergio Fanella; James Fraser; Zhancheng Gao; Patrick Gérardin; Maddalena Giannella; Sophie Gubbels; Jethro Herberg; Anjarath L. Higuera Iglesias; Peter H. Hoeger; Matthias Hoffmann; Xiaoyun Hu; Quazi T. Islam; Mirela F. Jiménez; Amr Kandeel; Gerben Keijzers; Hossein Khalili; Gulam Khandaker; Marian Knight; Gabriela Kusznierz; Ilija Kuzman; Arthur M.C. Kwan; Idriss Lahlou Amine; Eduard Langenegger; Kamran B. Lankarani; Ilkay Bozkurt

doi:10.1111/irv.12363

Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis

Stella G. Muthuri, Sudhir Venkatesan, Puja R. Myles, Jo Leonardi-Bee, Wei Shen Lim, Abdullah Al Mamun, Ashish P. Anovadiya, Wildo N. Araújo, Eduardo Azziz-Baumgartner, Clarisa Báez, Carlos Bantar, Mazen M. Barhoush, Matteo Bassetti, Bojana Beovic, Roland Bingisser, Isabelle Bonmarin, Victor H. Borja-Aburto, Bin Cao, Jordi Carratala, María R. CuezzoJustin T. Denholm, Samuel R. Dominguez, Pericles A.D. Duarte, Gal Dubnov-Raz, Marcela Echavarria, Sergio Fanella, James Fraser, Zhancheng Gao, Patrick Gérardin, Maddalena Giannella, Sophie Gubbels, Jethro Herberg, Anjarath L. Higuera Iglesias, Peter H. Hoeger, Matthias Hoffmann, Xiaoyun Hu, Quazi T. Islam, Mirela F. Jiménez, Amr Kandeel, Gerben Keijzers, Hossein Khalili, Gulam Khandaker, Marian Knight, Gabriela Kusznierz, Ilija Kuzman, Arthur M.C. Kwan, Idriss Lahlou Amine, Eduard Langenegger, Kamran B. Lankarani, Ilkay Bozkurt

Liverpool School of Tropical Medicine

Research output: Contribution to journal › Article › peer-review

59 Citations (Scopus)

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.

Original language	English
Pages (from-to)	192-204
Number of pages	13
Journal	Influenza and other Respiratory Viruses
Volume	10
Issue number	3
DOIs	https://doi.org/10.1111/irv.12363
Publication status	Published - 1 May 2016

Keywords

Hospitalisation
Individual participant data meta-analyses
Influenza-related pneumonia
Neuraminidase inhibitors

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10.1111/irv.12363Licence: CC BY

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Muthuri, S. G., Venkatesan, S., Myles, P. R., Leonardi-Bee, J., Lim, W. S., Al Mamun, A., Anovadiya, A. P., Araújo, W. N., Azziz-Baumgartner, E., Báez, C., Bantar, C., Barhoush, M. M., Bassetti, M., Beovic, B., Bingisser, R., Bonmarin, I., Borja-Aburto, V. H., Cao, B., Carratala, J., ... Bozkurt, I. (2016). Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis. Influenza and other Respiratory Viruses, 10(3), 192-204. https://doi.org/10.1111/irv.12363

@article{9ab3e22d96ae425f94d8e424e442ddf8,

title = "Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis",

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.",

keywords = "Hospitalisation, Individual participant data meta-analyses, Influenza-related pneumonia, Neuraminidase inhibitors",

author = "Muthuri, \{Stella G.\} and Sudhir Venkatesan and Myles, \{Puja R.\} and Jo Leonardi-Bee and Lim, \{Wei Shen\} and \{Al Mamun\}, Abdullah and Anovadiya, \{Ashish P.\} and Ara{\'u}jo, \{Wildo N.\} and Eduardo Azziz-Baumgartner and Clarisa B{\'a}ez and Carlos Bantar and Barhoush, \{Mazen M.\} and Matteo Bassetti and Bojana Beovic and Roland Bingisser and Isabelle Bonmarin and Borja-Aburto, \{Victor H.\} and Bin Cao and Jordi Carratala and Cuezzo, \{Mar{\'i}a R.\} and Denholm, \{Justin T.\} and Dominguez, \{Samuel R.\} and Duarte, \{Pericles A.D.\} and Gal Dubnov-Raz and Marcela Echavarria and Sergio Fanella and James Fraser and Zhancheng Gao and Patrick G{\'e}rardin and Maddalena Giannella and Sophie Gubbels and Jethro Herberg and \{Higuera Iglesias\}, \{Anjarath L.\} and Hoeger, \{Peter H.\} and Matthias Hoffmann and Xiaoyun Hu and Islam, \{Quazi T.\} and Jim{\'e}nez, \{Mirela F.\} and Amr Kandeel and Gerben Keijzers and Hossein Khalili and Gulam Khandaker and Marian Knight and Gabriela Kusznierz and Ilija Kuzman and Kwan, \{Arthur M.C.\} and \{Lahlou Amine\}, Idriss and Eduard Langenegger and Lankarani, \{Kamran B.\} and Ilkay Bozkurt",

year = "2016",

month = may,

day = "1",

doi = "10.1111/irv.12363",

language = "English",

volume = "10",

pages = "192--204",

journal = "Influenza and other Respiratory Viruses",

issn = "1750-2640",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "3",

}

Muthuri, SG, Venkatesan, S, Myles, PR, Leonardi-Bee, J, Lim, WS, Al Mamun, A, Anovadiya, AP, Araújo, WN, Azziz-Baumgartner, E, Báez, C, Bantar, C, Barhoush, MM, Bassetti, M, Beovic, B, Bingisser, R, Bonmarin, I, Borja-Aburto, VH, Cao, B, Carratala, J, Cuezzo, MR, Denholm, JT, Dominguez, SR, Duarte, PAD, Dubnov-Raz, G, Echavarria, M, Fanella, S, Fraser, J, Gao, Z, Gérardin, P, Giannella, M, Gubbels, S, Herberg, J, Higuera Iglesias, AL, Hoeger, PH, Hoffmann, M, Hu, X, Islam, QT, Jiménez, MF, Kandeel, A, Keijzers, G, Khalili, H, Khandaker, G, Knight, M, Kusznierz, G, Kuzman, I, Kwan, AMC, Lahlou Amine, I, Langenegger, E, Lankarani, KB & Bozkurt, I 2016, 'Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis', Influenza and other Respiratory Viruses, vol. 10, no. 3, pp. 192-204. https://doi.org/10.1111/irv.12363

Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis. / Muthuri, Stella G.; Venkatesan, Sudhir; Myles, Puja R. et al.
In: Influenza and other Respiratory Viruses, Vol. 10, No. 3, 01.05.2016, p. 192-204.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis

AU - Muthuri, Stella G.

AU - Venkatesan, Sudhir

AU - Myles, Puja R.

AU - Leonardi-Bee, Jo

AU - Lim, Wei Shen

AU - Al Mamun, Abdullah

AU - Anovadiya, Ashish P.

AU - Araújo, Wildo N.

AU - Azziz-Baumgartner, Eduardo

AU - Báez, Clarisa

AU - Bantar, Carlos

AU - Barhoush, Mazen M.

AU - Bassetti, Matteo

AU - Beovic, Bojana

AU - Bingisser, Roland

AU - Bonmarin, Isabelle

AU - Borja-Aburto, Victor H.

AU - Cao, Bin

AU - Carratala, Jordi

AU - Cuezzo, María R.

AU - Denholm, Justin T.

AU - Dominguez, Samuel R.

AU - Duarte, Pericles A.D.

AU - Dubnov-Raz, Gal

AU - Echavarria, Marcela

AU - Fanella, Sergio

AU - Fraser, James

AU - Gao, Zhancheng

AU - Gérardin, Patrick

AU - Giannella, Maddalena

AU - Gubbels, Sophie

AU - Herberg, Jethro

AU - Higuera Iglesias, Anjarath L.

AU - Hoeger, Peter H.

AU - Hoffmann, Matthias

AU - Hu, Xiaoyun

AU - Islam, Quazi T.

AU - Jiménez, Mirela F.

AU - Kandeel, Amr

AU - Keijzers, Gerben

AU - Khalili, Hossein

AU - Khandaker, Gulam

AU - Knight, Marian

AU - Kusznierz, Gabriela

AU - Kuzman, Ilija

AU - Kwan, Arthur M.C.

AU - Lahlou Amine, Idriss

AU - Langenegger, Eduard

AU - Lankarani, Kamran B.

AU - Bozkurt, Ilkay

PY - 2016/5/1

Y1 - 2016/5/1

N2 - 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.

AB - 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.

KW - Hospitalisation

KW - Individual participant data meta-analyses

KW - Influenza-related pneumonia

KW - Neuraminidase inhibitors

U2 - 10.1111/irv.12363

DO - 10.1111/irv.12363

M3 - Article

SN - 1750-2640

VL - 10

SP - 192

EP - 204

JO - Influenza and other Respiratory Viruses

JF - Influenza and other Respiratory Viruses

IS - 3

ER -

Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis: An individual participant data meta-analysis

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