Results of a study published in JAMA Internal Medicine show that oseltamivir is not associated with reduced risk for all-cause hospitalization among patients with influenza virus infection.
Researchers conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to assess the efficacy and safety of oseltamivir in preventing hospitalization among adults and adolescents with influenza infection. Eligible trials were designed to compare hospitalization outcomes following treatment with either oseltamivir 75 mg twice daily for 5 days or a nonactive control equivalent (placebo or standard care). The primary efficacy outcome was the number of first all-cause hospitalizations among the intention-to-treat (ITT) population, defined as patients with confirmed influenza infection. The primary safety outcome was the rate of any adverse event (AE).
The final analysis included 15 RCTs, representing a total of 6295 patients in the ITT population. Among all patients, 53.6% were women, 70.2% were White, the mean (SD) age was 45.3 (14.5) years, and 60.3% were infected with influenza type A.
The researchers found that oseltamivir was not associated with reduced risk for first all-cause hospitalization in the overall population (risk ratio [RR], 0.77; 95% CI, 0.47-1.27).
In subgroup analyses, oseltamivir was not associated with reduced risk for all-cause hospitalization among older (mean age, ≥65 years; RR, 0.99; 95% CI, 0.19-5.13) vs younger (mean age, <65 years; RR, 0.72; 95% CI, 0.39-1.34) patients. There also was no risk reduction observed between high-risk patients (RR, 0.90; 95% CI, 0.37-2.17) and low-risk patients (RR, 0.63; 95% CI, 0.32-1.24) following treatment with oseltamivir.
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[T]here is a lack of convincing evidence that oseltamivir reduces serious complications in outpatients with influenza…
In regard to AEs, patients who received oseltamivir were significantly more likely to experience nausea (RR, 1.43; 95% CI, 1.13-1.82), vomiting (RR, 1.83; 95% CI, 1.28-2.63), and a composite of gastrointestinal symptoms (RR, 1.21; 95% CI, 1.02-1.45). However, no significant increase in the rate of severe AEs was observed among patients in oseltamivir vs control groups (RR, 0.71; 95% CI, 0.46-1.08).
Study limitations include potentially insufficient power due the younger patient population and low rate of hospitalization. In addition, the researchers did not consider observational data or the occurrence of symptomatic improvement.
According to the researchers, “[T]here is a lack of convincing evidence that oseltamivir reduces serious complications in outpatients with influenza…”
Disclosures: Multiple authors declared affiliations with pharmaceutical, biotech, and/or device companies. Please see the original reference for a full list of disclosures.
This article originally appeared on Infectious Disease Advisor
