tetano
Editor, Senior Moderator
Clinical Infectious Diseases 2010;51:000?000
? 2010 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2010/5110-00XX$15.00
DOI: 10.1086/656802
MAJOR ARTICLE
Long‐Acting Neuraminidase Inhibitor Laninamivir Octanoate versus Oseltamivir for Treatment of Influenza: A Double‐Blind, Randomized, Noninferiority Clinical Trial
Akira Watanabe,1
Shan‐Chwen Chang,3
Min Ja Kim,4
Daniel Wai‐sing Chu,5 and
Yasuo Ohashi2;
for the MARVEL Study Groupa
1Research Division for Development of Anti‐Infective Agents, Institute of Development, Aging and Cancer, Tohoku University, Sendai, 2Department of Biostatistics, School of Public Health Science, University of Tokyo, Tokyo, Japan; 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Division of Infectious Diseases, Korea University Medical Center, Anam Hospital, Seoul, Korea; and 5Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
Background.A single administration of laninamivir octanoate, a long‐acting neuraminidase inhibitor, against influenza infection has been proven effective in nonclinical studies. This study evaluated the clinical efficacy of laninamivir octanoate for the treatment of adult influenza patients.
Methods.A double‐blind, randomized controlled trial examined whether laninamivir octanoate was noninferior to oseltamivir. A total of 1003 patients aged 20 years with febrile influenza symptoms for no more than 36 h were randomized to receive either 40 mg of laninamivir octanoate, 20 mg of laninamivir octanoate, or oseltamivir. Laninamivir octanoate was inhaled once on day 1, and oseltamivir (75 mg) was administered orally twice daily for 5 days. The primary end point was the time to illness alleviation.
Results.A total of 996 patients were included in the primary analysis (40‐mg laninamivir octanoate, ; 20‐mg laninamivir octanoate, ; and oseltamivir, ). The median time to illness alleviation in the 40‐mg laninamivir octanoate, 20‐mg laninamivir octanoate, and oseltamivir groups was 73.0, 85.8, and 73.6 h, respectively. The difference between laninamivir octanoate and oseltamivir was −0.6 h (95% confidence interval, −9.9 to 6.9 h) for the 40‐mg group and 12.2 h (95% confidence interval, −1.5 to 17.2 h) for the 20‐mg group. The upper limits of the 95% confidence intervals were less than the prespecified noninferiority margin (18 h). The proportion of patients shedding virus at day 3 was significantly lower in the 40‐mg laninamivir octanoate group than in the oseltamivir group ( ).
Conclusions.A single inhalation of laninamivir octanoate is effective for the treatment of seasonal influenza, including that caused by oseltamivir‐resistant virus, in adults.
http://www.journals.uchicago.edu/doi/abs/10.1086/656802
? 2010 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2010/5110-00XX$15.00
DOI: 10.1086/656802
MAJOR ARTICLE
Long‐Acting Neuraminidase Inhibitor Laninamivir Octanoate versus Oseltamivir for Treatment of Influenza: A Double‐Blind, Randomized, Noninferiority Clinical Trial
Akira Watanabe,1
Shan‐Chwen Chang,3
Min Ja Kim,4
Daniel Wai‐sing Chu,5 and
Yasuo Ohashi2;
for the MARVEL Study Groupa
1Research Division for Development of Anti‐Infective Agents, Institute of Development, Aging and Cancer, Tohoku University, Sendai, 2Department of Biostatistics, School of Public Health Science, University of Tokyo, Tokyo, Japan; 3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 4Division of Infectious Diseases, Korea University Medical Center, Anam Hospital, Seoul, Korea; and 5Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
Background.A single administration of laninamivir octanoate, a long‐acting neuraminidase inhibitor, against influenza infection has been proven effective in nonclinical studies. This study evaluated the clinical efficacy of laninamivir octanoate for the treatment of adult influenza patients.
Methods.A double‐blind, randomized controlled trial examined whether laninamivir octanoate was noninferior to oseltamivir. A total of 1003 patients aged 20 years with febrile influenza symptoms for no more than 36 h were randomized to receive either 40 mg of laninamivir octanoate, 20 mg of laninamivir octanoate, or oseltamivir. Laninamivir octanoate was inhaled once on day 1, and oseltamivir (75 mg) was administered orally twice daily for 5 days. The primary end point was the time to illness alleviation.
Results.A total of 996 patients were included in the primary analysis (40‐mg laninamivir octanoate, ; 20‐mg laninamivir octanoate, ; and oseltamivir, ). The median time to illness alleviation in the 40‐mg laninamivir octanoate, 20‐mg laninamivir octanoate, and oseltamivir groups was 73.0, 85.8, and 73.6 h, respectively. The difference between laninamivir octanoate and oseltamivir was −0.6 h (95% confidence interval, −9.9 to 6.9 h) for the 40‐mg group and 12.2 h (95% confidence interval, −1.5 to 17.2 h) for the 20‐mg group. The upper limits of the 95% confidence intervals were less than the prespecified noninferiority margin (18 h). The proportion of patients shedding virus at day 3 was significantly lower in the 40‐mg laninamivir octanoate group than in the oseltamivir group ( ).
Conclusions.A single inhalation of laninamivir octanoate is effective for the treatment of seasonal influenza, including that caused by oseltamivir‐resistant virus, in adults.
http://www.journals.uchicago.edu/doi/abs/10.1086/656802