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

  • PRIDE Consortium Investigators
  • , 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
  • University of Nottingham
  • Nottingham University Hospitals NHS Trust
  • International Centre for Diarrhoeal Disease Research Bangladesh
  • Government Medical College Bhavnagar
  • Universidade de Brasília
  • Centers for Disease Control and Prevention
  • Instituto Nacional de Epidemiología Dr. Juan H. Jara
  • Hospital San Martín de Paraná
  • King Saud Medical City
  • Santa Maria Misericordia Hospital
  • University Medical Centre Ljubljana
  • University of Basel
  • Institut de veille sanitaire
  • Instituto Mexicano del Seguro Social
  • Capital Medical University
  • Hospital Universitari de Bellvitge
  • Ministerio de Salud
  • University of Melbourne
  • University of Colorado Anschutz Medical Campus
  • Universidade Estadual do Oeste do Paraná
  • Sheba Medical Center at Tel Hashomer
  • Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno
  • University of Manitoba
  • University Hospitals Bristol and Weston NHS Foundation Trust
  • Peking University
  • CHU Saint Pierre
  • Institut national de la santé et de la recherche médicale
  • NICU/PICU CHU of La Réunion
  • Hospital General Universitario Gregorio Marañon
  • Statens Serum Institut
  • Imperial College London
  • Instituto Nacional de Enfermedades Respiratorias
  • Cath. Children's Hospital Wilhelmstift
  • Cantonal Hospital St. Gallen
  • Chinese Academy of Medical Sciences
  • Dhaka Medical College Hospital
  • Universidade Federal de Ciências da Saúde de Porto Alegre
  • Ministry of Health and Population
  • Griffith University and Gold Coast University Hospital
  • Tehran University of Medical Sciences
  • University of Sydney
  • University of Oxford
  • Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"
  • Dr. Fran Mihaljevic University Hospital for Infectious Diseases
  • Pamela Youde Nethersole Eastern Hospital
  • Military Hospital Mohammed V
  • Stellenbosch University
  • Shiraz University of Medical Sciences

Research output: Contribution to journalArticlepeer-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 languageEnglish
Pages (from-to)192-204
Number of pages13
JournalInfluenza and other Respiratory Viruses
Volume10
Issue number3
DOIs
Publication statusPublished - 1 May 2016

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

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

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