Comparison of Efficacy of Intravenous Peramivir and Oral Oseltamivir for the Treatment of Influenza: Systematic Review and Meta-Analysis.
10.3349/ymj.2017.58.4.778
- Author:
Jonghoo LEE
1
;
Ju Hee PARK
;
Hyeyoung JWA
;
Yee Hyung KIM
Author Information
1. Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.
- Publication Type:Meta-Analysis ; Randomized Controlled Trial ; Original Article
- Keywords:
Influenza;
human;
peramivir;
oseltamivir;
fever;
signs and symptoms;
respiratory
- MeSH:
Fever;
Humans;
Incidence;
Influenza, Human*;
Length of Stay;
Mortality;
Oseltamivir*;
Outpatients;
Seasons;
Viral Load
- From:Yonsei Medical Journal
2017;58(4):778-785
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Peramivir is the first intravenously administered neuramidase inhibitor for immediate delivery of an effective single-dose treatment in patients with influenza. However, limited data are available on intravenous (IV) peramivir treatment compared to oral oseltamivir for these patients. MATERIALS AND METHODS: With a systematic review and meta-analysis, we compared the efficacy of IV peramivir with oral oseltamivir for treatment of patients with seasonal influenza. MEDLINE, EMBASE, and Cochrane Central Register were searched for relevant clinical trials. RESULTS: A total of seven trials [two randomized controlled trials (RCTs) and five non-randomized observational trials] involving 1676 patients were finally analyzed. The total number of peramivir- and oseltamivir-treated patients was 956 and 720, respectively. Overall, the time to alleviation of fever was lower in the peramivir-treated group compared with the oseltamivir-treated group [mean difference (MD), −7.17 hours; 95% confidence interval (CI) −11.00 to −3.34]. Especially, pooled analysis of observational studies (n=4) and studies of outpatients (n=4) demonstrated the superiority of the peramivir-treated group (MD, -7.83 hours; 95% CI −11.81 to −3.84 and MD, −7.71 hours; 95% CI −11.61 to −3.80, respectively). Mortality, length of hospital stay, change in virus titer 48 hours after admission, and the incidence of adverse events in these patients were not significantly different between the two groups. CONCLUSION: IV peramivir therapy might reduce the time to alleviation of fever in comparison with oral oseltamivir therapy in patients with influenza; however, we could not draw clear conclusions from a meta-analysis because of the few RCTs available and methodological limitations.
