Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Effectiveness of oseltamivir in adults: a meta-analysis of published and unpublished clinical trials

Effectiveness of oseltamivir in adults: a meta-analysis of published and unpublished clinical trials Background.Oseltamivir is widely used for the treatment of influenza. Previous systematic reviews suggest that they reduce complications, but had significant methodologic limitations.Objective.To assess the effect of oseltamivir on duration of symptoms, complications and hospitalizations in adults.Methods.We searched Medline without time or language restrictions, and trial registries maintained by the manufacturer. We included published and unpublished randomized double-blinded, placebo-controlled trials of oseltamivir in adults with suspected influenza that reported duration of symptoms, complications or hospitalizations. We abstracted data regarding study quality, the duration of symptoms and rates of complications and hospitalization.Results.Three published and eight unpublished studies met our inclusion criteria. For the intention-to-treat (ITT) population, the mean reduction in the duration of symptoms was 20.7 hours [95% confidence interval (CI) 13.3 to 28.0 hours]. Two large unpublished studies in the elderly and in adults with chronic disease did not find a significant reduction in the symptom duration. There was no difference in the likelihood of hospitalization in the ITT population (33/2633 patients for oseltamivir versus 20/1694 for placebo). The rate of complications in the intention-to-treat infected (ITTI) population was reduced when acute bronchitis was included (−2.8%, 95% CI −0.6 to −4.9), but not when it was excluded. The risk of pneumonia was reduced in the ITTI population (−0.9%, 95% CI −0.1 to −1.7) but not in the ITT population.Conclusions.There is no evidence that oseltamivir reduces the likelihood of hospitalization, pneumonia or the combined outcome of pneumonia, otitis media and sinusitis in the ITT population. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Family Practice Oxford University Press

Effectiveness of oseltamivir in adults: a meta-analysis of published and unpublished clinical trials

Family Practice , Volume 30 (2) – Apr 21, 2013

Loading next page...
 
/lp/oxford-university-press/effectiveness-of-oseltamivir-in-adults-a-meta-analysis-of-published-b1qXWamMEj

References (24)

Publisher
Oxford University Press
Copyright
© The Author 2012. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Subject
Review
ISSN
0263-2136
eISSN
1460-2229
DOI
10.1093/fampra/cms059
pmid
22997224
Publisher site
See Article on Publisher Site

Abstract

Background.Oseltamivir is widely used for the treatment of influenza. Previous systematic reviews suggest that they reduce complications, but had significant methodologic limitations.Objective.To assess the effect of oseltamivir on duration of symptoms, complications and hospitalizations in adults.Methods.We searched Medline without time or language restrictions, and trial registries maintained by the manufacturer. We included published and unpublished randomized double-blinded, placebo-controlled trials of oseltamivir in adults with suspected influenza that reported duration of symptoms, complications or hospitalizations. We abstracted data regarding study quality, the duration of symptoms and rates of complications and hospitalization.Results.Three published and eight unpublished studies met our inclusion criteria. For the intention-to-treat (ITT) population, the mean reduction in the duration of symptoms was 20.7 hours [95% confidence interval (CI) 13.3 to 28.0 hours]. Two large unpublished studies in the elderly and in adults with chronic disease did not find a significant reduction in the symptom duration. There was no difference in the likelihood of hospitalization in the ITT population (33/2633 patients for oseltamivir versus 20/1694 for placebo). The rate of complications in the intention-to-treat infected (ITTI) population was reduced when acute bronchitis was included (−2.8%, 95% CI −0.6 to −4.9), but not when it was excluded. The risk of pneumonia was reduced in the ITTI population (−0.9%, 95% CI −0.1 to −1.7) but not in the ITT population.Conclusions.There is no evidence that oseltamivir reduces the likelihood of hospitalization, pneumonia or the combined outcome of pneumonia, otitis media and sinusitis in the ITT population.

Journal

Family PracticeOxford University Press

Published: Apr 21, 2013

Keywords: Keywords. Hospitalization influenza meta-analysis oseltamivir systematic review.

There are no references for this article.