• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Emergency

Antiviral agents such as zanamivir and baloxavir are associated with improved time to symptom alleviation for seasonal influenza

byGursharan SohiandMichael Pratte
August 16, 2021
in Emergency, Infectious Disease
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. This network meta-analysis of randomized controlled trials (RCTs) concluded that four antiviral medications successfully reduce the duration of influenza symptoms, of which zanamivir was associated with the shortest time to alleviation of influenza symptoms (TTAS).

2. Baloxavir was associated with the lowest overall risk of influenza-related complications of the antivirals included.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Seasonal influenza is a common and potentially deadly illness in many parts of the world. Recently, Influenza A or B coinfection with the COVID-19 virus has increased the risk that each of these illnesses pose to individuals and healthcare systems globally. This systematic review and meta-analysis summarized high-quality evidence from RCTs evaluating antiviral medications recommended for influenza treatment: oseltamivir, oral baloxavir, inhaled zanamivir and intravenous peramivir. 26 studies were included with 11,897 participants in total. 15 trials were included in the analysis of antiviral efficacy for reduced symptom duration; 10mg zanamivir was associated with the shortest TTAS compared to placebo. Baloxavir reduced TTAS compared to placebo, but was the least effective of the evaluated antivirals at doing so. However, baloxavir was associated with the lowest risk of overall influenza-related complications as assessed through 21 trials, while zanamivir was associated with the highest complication rate. Finally, drug safety outcomes were assessed: Liu et al concluded that baloxavir was significantly associated with the lowest rate of treatment-related adverse events and peramivir with the highest. Sensitivity analysis was performed to remove studies with high risk of bias; this did not change the conclusions with regards to estimates of TTAS. Liu et al’s analysis of antiviral medications for the treatment of seasonal influenza provides thorough evidence for the advantages and disadvantages of several common agents. These findings are plausible given the known properties of the antiviral agents used in this study; this work strengthens the argument for early empiric treatment of influenza-like illnesses with antivirals to reduce symptom duration and complication rates with relatively few adverse events. The findings reported here are strengthened by the relatively large sample size and thorough statistical analysis. The authors conducted a rigorous evaluation of study quality & concluded that low quality studies had not introduced bias to their results. Interestingly, median TTAS durations were not reported in order to reduce bias due to missing data. Instead, hazard ratios were calculated for the relative differences in TTAS between drugs. A primary drawback of the study is the subjectivity of patient-reported data in defining influenza-like symptoms.

Click to read this study in JAMA Network Open

Related Reading: Combining antivirals and immunomodulators to fight COVID-19

In-depth [systematic review & meta-analysis]: Eligible studies were RCTs comparing neuraminidase inhibitors (oseltamivir, zanamivir, peramivir, laninamivir) or endonuclease inhibitors (baloxavir) to each other and/or to placebo in otherwise healthy adults and children. Most trials included otherwise-healthy patients of all ages, with 12 (36%) focussing on only adults and 5 (15%) assessing only children. TTAS was defined as the time from the start of antiviral treatment to patient-reported relief of all influenza-like symptoms. Three databases were searched from their inception point until January, 2020, and data was extracted independently by two reviewers. The Cochrane Risk of Bias tool was used to assess study quality; a multivariate random effects model was used for the statistical analysis using R software. Study drugs are ranked according to shortest to longest TTAS compared with placebo, as follows: 10mg zanamivir (Hazard Ratio [HR] 0.67, 95% Confidence Interval [95CI] 0.58-0.77), 600mg peramivir (HR 0.69; 95CI, 0.54-0.88), 75mg oseltamivir (HR 0.74; 95CI, 0.70-0.79), 150 mg oseltamivir (HR 0.75; 95CI, 0.65-0.86), 300mg peramivir (HR 0.75; 95CI, 0.62-0.91), 40mg or 80mg baloxavir (HR 0.79; 95CI, 0.73-0.86). Influenza complication rates were assessed using the relative risk (RR) compared to placebo. Baloxavir (40mg or 80mg dose) was associated with a RR of 0.51 (95CI 0.32-0.80) for influenza-related complications. The RR for influenza complications amongst patients treated with zanamivir was 0.82 (95CI 0.72-0.92). An Egger test and funnel plot to assess for publication bias concluded that positive studies may have been more likely to be published.

RELATED REPORTS

Influenza is associated with an increased odds of Parkinson Disease diagnosis after 10 years

#VisualAbstract: Plant-based QVLP influenza vaccine likely non-inferior to commercial inactivated vaccines

Plant-based QVLP influenza vaccine likely non-inferior to commercial inactivated vaccines

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: antiviral medicationsantiviralsFlu (Influenza)influenza
Previous Post

Non-vitamin K oral anticoagulants associated with superior stroke prevention over warfarin among patients with nonvalvular atrial fibrillation

Next Post

Pain and sleep may have a bidirectional causal relationship

RelatedReports

Influenza vaccine not associated with increased risk of epilepsy in children
Infectious Disease

Influenza is associated with an increased odds of Parkinson Disease diagnosis after 10 years

October 26, 2021
#VisualAbstract: Plant-based QVLP influenza vaccine likely non-inferior to commercial inactivated vaccines
StudyGraphics

#VisualAbstract: Plant-based QVLP influenza vaccine likely non-inferior to commercial inactivated vaccines

November 26, 2020
Influenza vaccine not associated with increased risk of epilepsy in children
Infectious Disease

Plant-based QVLP influenza vaccine likely non-inferior to commercial inactivated vaccines

November 22, 2020
Late pregnancy pertussis vaccination may boost passive immunity
Infectious Disease

Influenza vaccination linked to slight increased risk of subdeltoid bursitis

June 28, 2020
Next Post
Circulating tumor DNA used to monitor metastatic breast cancer

Pain and sleep may have a bidirectional causal relationship

ICU chlorhexidine baths do not reduce rates of hospital-acquired infections

Milrinone and dobutamine show no difference for cardiogenic shock treatment

Quick Take: Safety and Efficacy of Ozanimod Versus Interferon Beta-1a in Relapsing Multiple Sclerosis (SUNBEAM)

Differences in national strategies for the treatment of relapsing-remitting multiple sclerosis significantly associated with disability outcomes during follow-up

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Stereotactic body radiotherapy as a state of the art treatment option in inoperable non-small cell lung cancer [Classics Series]
  • Health system-based care associated with better treatment use and high rates of tobacco abstinence at 3 months post-discharge in hospitalized smokers
  • APOEε4 genotype may increase risk of chronic traumatic encephalopathy following repetitive head impact
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.