tetano
Editor, Senior Moderator
Open Forum Infect Dis. 2017 Jun 19;4(3)
fx129. doi: 10.1093/ofid/ofx129. eCollection 2017 Summer.
[h=1]Efficacy and Safety of Intravenous Peramivir Compared With Oseltamivir in High-Risk Patients Infected With Influenza A and B Viruses: A Multicenter Randomized Controlled Study.[/h] Nakamura S[SUP]1,[/SUP][SUP]2[/SUP], Miyazaki T[SUP]1,[/SUP][SUP]3[/SUP], Izumikawa K[SUP]3[/SUP], Kakeya H[SUP]4[/SUP], Saisho Y[SUP]5[/SUP], Yanagihara K[SUP]6[/SUP], Miyazaki Y[SUP]2[/SUP], Mukae H[SUP]1[/SUP], Kohno S[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Clinical studies comparing the different neuraminidase inhibitors for treatment of at-risk patients with influenza have not been performed. To optimize such treatments, we assessed the efficacy and safety of intravenous peramivir compared with oral oseltamivir in treating seasonal influenza A or B virus infection.
[h=4]METHODS:[/h] A multicenter, randomized, controlled clinical trial was conducted from December 2012 to May 2014 in high-risk patients infected with seasonal influenza. A total of 92 adult inpatients and outpatients with high risk factors (HRFs) were treated by either a single intravenous infusion of peramivir (600 mg) or oral administration of oseltamivir (75 mg, twice per day for 5 days).
[h=4]RESULTS:[/h] The median times to clinical stability (time to reach <37?C) were 40.0 hours (95% confidence interval [CI] = 23.3-64.5) and 37.8 hours (95% CI = 26.3-45.3) in the peramivir and oseltamivir groups, respectively; these values did not reveal a significant difference. The virus titer and change of mean total symptom scores decreased similarly with both treatments. Results of step-wise regression suggested that virus type was a significantly effective prognostic factor with respect to illness resolution. Adverse events (AEs) with peramivir and oseltamivir occurred in 2.2% (n = 1/46) and 13.0% (n = 6/46) of patients, respectively. The severity of AEs was mild in all cases except 2 patients who showed pneumonia or COPD aggravation; both were in the oseltamivir group.
[h=4]CONCLUSIONS:[/h] Intravenous peramivir was effective based on the result of direct comparison with oral oseltamivir. Thus our data show that peramivir is a useful option for the treatment of influenza-infected patients with HRFs.
[h=4]KEYWORDS:[/h] high-risk patient; influenza; neuraminidase inhibitor; oseltamivir; peramivir
PMID: 28761899 PMCID: PMC5534217 DOI: 10.1093/ofid/ofx129
Free PMC Article
fx129. doi: 10.1093/ofid/ofx129. eCollection 2017 Summer.[h=1]Efficacy and Safety of Intravenous Peramivir Compared With Oseltamivir in High-Risk Patients Infected With Influenza A and B Viruses: A Multicenter Randomized Controlled Study.[/h] Nakamura S[SUP]1,[/SUP][SUP]2[/SUP], Miyazaki T[SUP]1,[/SUP][SUP]3[/SUP], Izumikawa K[SUP]3[/SUP], Kakeya H[SUP]4[/SUP], Saisho Y[SUP]5[/SUP], Yanagihara K[SUP]6[/SUP], Miyazaki Y[SUP]2[/SUP], Mukae H[SUP]1[/SUP], Kohno S[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Clinical studies comparing the different neuraminidase inhibitors for treatment of at-risk patients with influenza have not been performed. To optimize such treatments, we assessed the efficacy and safety of intravenous peramivir compared with oral oseltamivir in treating seasonal influenza A or B virus infection.
[h=4]METHODS:[/h] A multicenter, randomized, controlled clinical trial was conducted from December 2012 to May 2014 in high-risk patients infected with seasonal influenza. A total of 92 adult inpatients and outpatients with high risk factors (HRFs) were treated by either a single intravenous infusion of peramivir (600 mg) or oral administration of oseltamivir (75 mg, twice per day for 5 days).
[h=4]RESULTS:[/h] The median times to clinical stability (time to reach <37?C) were 40.0 hours (95% confidence interval [CI] = 23.3-64.5) and 37.8 hours (95% CI = 26.3-45.3) in the peramivir and oseltamivir groups, respectively; these values did not reveal a significant difference. The virus titer and change of mean total symptom scores decreased similarly with both treatments. Results of step-wise regression suggested that virus type was a significantly effective prognostic factor with respect to illness resolution. Adverse events (AEs) with peramivir and oseltamivir occurred in 2.2% (n = 1/46) and 13.0% (n = 6/46) of patients, respectively. The severity of AEs was mild in all cases except 2 patients who showed pneumonia or COPD aggravation; both were in the oseltamivir group.
[h=4]CONCLUSIONS:[/h] Intravenous peramivir was effective based on the result of direct comparison with oral oseltamivir. Thus our data show that peramivir is a useful option for the treatment of influenza-infected patients with HRFs.
[h=4]KEYWORDS:[/h] high-risk patient; influenza; neuraminidase inhibitor; oseltamivir; peramivir
PMID: 28761899 PMCID: PMC5534217 DOI: 10.1093/ofid/ofx129
Free PMC Article