2024-03-28T09:21:05Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00034042
2022-12-15T04:04:25Z
453:455
471:561:562
Effectiveness of four types of neuraminidase inhibitors approved in Japan for the treatment of influenza
インフルエンザ治療薬として日本で承認されている4種のノイラミニダーゼ阻害剤の効果
Mawatari, Momoko
【○!C】 2019 Mawatari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.
Background Neuraminidase inhibitors (NAIs) effectively treat influenza. The clinical effectiveness of four NAIs (oseltamivir, zanamivir, laninamivir, and peramivir) was evaluated against influenza A/H1N1pdm09, A/H3N2, and B viruses. Additionally, fever duration in patients infected with oseltamivir-resistant influenza A/H1N1pdm09 with the H275Y mutation was evaluated. Methods Patients aged < 20 years who visited outpatient clinics in Japan with influenza-like illnesses were enrolled during 4 influenza seasons from 2012/2013 to 2015/2016. After obtaining informed consent, patients who tested positive for influenza with rapid tests received one of the four NAIs. Patients recorded their body temperature daily for 8 days from the first visit. The influenza strain was identified using real-time polymerase chain reaction. Univariate and multivariable analyses were used to evaluate factors influencing fever duration. In children aged <___ 5 years treated with oseltamivir, fever duration in oseltamivir-resistant A/H1N1pdm09-infected patients was compared to that in oseltamivir-sensitive A/H1N1pdm09-infected patients. Results Of the 1,368 patients analyzed, 297 (21.7%), 683 (49.9%), and 388 (28.4%) were infected with influenza A/H1N1pdm09, A/H3N2, and B, respectively. In multivariable analysis factors associated with significantly prolonged fever duration included: treatment with laninamivir (hazard ratio [HR]: 0.78, p = 0.006, compared to oseltamivir), influenza B (HR: 0.58, p < 0.001, compared to influenza A/H1N1pdm09), and a higher body temperature at the clinic visit (HR: 0.87 per degree Celsius, p < 0.001). Increasing age was associated with a significantly shorter duration of fever (HR: 1.31 for 6–9 years old, p < 0.001; and HR: 1.65 for 10–19 years old, p < 0.001, respectively, compared to 0–5 years old). Following treatment with oseltamivir, fever duration was significantly longer for oseltamivir-resistant A/H1N1pdm09-infected patients (n = 5) than for oseltamivir-sensitive A/H1N1pdm09-infected patients (n = 111) (mean, 89 versus 40 hours, p < 0.001). Conclusions Our results revealed characteristic information on the effectiveness of the four NAIs and also on oseltamivir-resistant viruses that may affect patients’ clinical care.
PLoS One. 2019, 14(11), e0224683.
新大院博(医)甲第951号
eng
thesis
http://hdl.handle.net/10191/00051840
https://niigata-u.repo.nii.ac.jp/records/34042
info:doi/10.1371/journal.pone.0224683
13101甲第4717号
博士(医学)
2020-03-23
新潟大学
https://niigata-u.repo.nii.ac.jp/record/34042/files/r1nmk951.pdf
application/pdf
1.7 MB
2020-08-31
https://niigata-u.repo.nii.ac.jp/record/34042/files/r1nmk951_a.pdf
application/pdf
571.9 kB
2020-08-31