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Volume 17, Number 9—September 2011

Research

Estimating Effect of Antiviral Drug Use during Pandemic (H1N1) 2009 Outbreak, United States

Charisma Y. Atkins, Anita Patel, Thomas H. Taylor, Matthew Biggerstaff, Toby L. Merlin, Stephanie M. Dulin, Benjamin A. Erickson, Rebekah H. Borse, Robert Hunkler, and Martin I. Meltzer
Author affiliations: Author affiliations: Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.Y. Atkins, A. Patel, T.H. Taylor, Jr., M. Biggerstaff, T.L. Merlin, S.M. Dulin, B.A. Erikson, R.H. Borse, M.I. Meltzer); IMS Health, Fountain Hills, Arizona, USA (R. Hunkler)

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Table 3

Literature review of effectiveness of neuraminidase inhibitors in preventing influenza-related hospitalizations*

Drug Study type Population Reduction in hospitalization point estimate (95% CI) Reference
Zanamivir Randomized, double-blind, placebo-controlled trial 455 patients residing in Australia, New Zealand, and South Africa age >12 y with influenza-like symptoms of <36 hours’ duration NA (14)
Oseltamivir Open-label, multicenter international study 1,426 patients (age range 12–70 y) seeking treatment <48 h after onset of influenza symptoms NA (15)
Oseltamivir Retrospective cohort analysis The oseltamivir and untreated control groups each included 36,751 eligible patients 22%;
HR 0.78 (0.67–0.91) (8);
claims data
Oseltamivir Retrospective cohort study Oseltamivir and untreated propensity matched control groups each included 45,751 eligible patients 30% any cause;
OR 0.71 (0.62–0.83) (9);
insurance claims data
Zanamivir Randomized, double-blind studies in 38 centers in North America and 32 centers in Europe during the 1994–95 influenza season 417 adults with influenza-like illness of
<48 hours' duration were randomly assigned to 1 of 3 treatments NA (16)
Amantadine/ rimantadine Two randomized, double-blind, placebo-controlled trials ≈80 patients with laboratory-documented influenza A virus (H3N2) illness <2 days' duration NA (13)
Oseltamivir Combined analysis of 10 prospective, placebo controlled, double-blind trials 3,564 persons (age range 13–97 y) with influenza-like illness enrolled in 10 placebo-controlled, double-blind trials of oseltamivir treatment 59% any cause reduction; 50% influenza, at risk patients (7)
Zanamivir Retrospective pooled analysis of data; all studies were randomized, double-blind, and placebo-controlled with 21–28 day follow-up 2,751 patients were recruited; of these,
321 (12%) were considered high risk
and 154 were randomized to receive zanamivir NA (17)
Zanamivir Randomized, double-blind, placebo-controlled trial in primary care and hospital clinics 356 patients age >12 y were recruited within
2 d of onset of typical influenza symptoms NA (12)
Zanamivir Pooled analyses of secondary endpoints NA (18)
Oseltamivir Randomized controlled trial 726 healthy nonimmunized adults with febrile influenza-like illness of <36 hours’ duration NA (19)
Oseltamivir Retrospective cohort study 9,090 patients with diabetes and influenza 30% any cause;
RR 0.70 (0.52–0.94) (10);
insurance claims data
Oseltamivir Retrospective cohort study The oseltamivir and untreated control groups each included 36,751 eligible patients, 50% with a claim for oseltamivir, 50% without 38%;
RR 0.62 (0.52–0.74) (11);
insurance claims data
Oseltamivir Double-blind, stratified, randomized, placebo-controlled, multicenter trial Healthy adults (age range 18–65 y) who sought treatment <36 h after onset of influenza symptoms NA (20)
Oseltamivir Randomized, double blind, placebo-controlled study Children age 1–12 y with fever (>100°F [>38°C]) and a history of cough or coryza
<48 hours’ duration NA (21)

*CI, confidence interval; NA, not applicable; HR, hazard ratio; OR, odds ratio; RR, relative risk.

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