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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 \u003c 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 \u003c___ 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 \u003c 0.001, compared to influenza A/H1N1pdm09), and a higher body temperature at the clinic visit (HR: 0.87 per degree Celsius, p \u003c 0.001). Increasing age was associated with a significantly shorter duration of fever (HR: 1.31 for 6–9 years old, p \u003c 0.001; and HR: 1.65 for 10–19 years old, p \u003c 0.001, respectively, compared to 0–5 years old). 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Effectiveness of four types of neuraminidase inhibitors approved in Japan for the treatment of influenza
http://hdl.handle.net/10191/00051840
http://hdl.handle.net/10191/000518403dfdd88f-8087-46eb-b406-6ad45abeb28e
名前 / ファイル | ライセンス | アクション |
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要旨 (571.9 kB)
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Item type | 学位論文 / Thesis or Dissertation(1) | |||||
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公開日 | 2020-08-31 | |||||
タイトル | ||||||
タイトル | Effectiveness of four types of neuraminidase inhibitors approved in Japan for the treatment of influenza | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_46ec | |||||
タイプ | thesis | |||||
その他のタイトル | ||||||
その他のタイトル | 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 | |||||
著者 |
Mawatari, Momoko
× Mawatari, Momoko |
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著者別名 | ||||||
識別子 | 178083 | |||||
識別子Scheme | WEKO | |||||
姓名 | 馬渡, 桃子 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 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. | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | PLoS One. 2019, 14(11), e0224683. | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | info:doi/10.1371/journal.pone.0224683 | |||||
権利 | ||||||
権利情報 | 【○!C】 2019 Mawatari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License. | |||||
著者版フラグ | ||||||
値 | ETD | |||||
学位名 | ||||||
学位名 | 博士(医学) | |||||
学位授与機関 | ||||||
学位授与機関名 | 新潟大学 | |||||
学位授与年月日 | ||||||
学位授与年月日 | 2020-03-23 | |||||
学位授与番号 | ||||||
学位授与番号 | 13101甲第4717号 | |||||
学位記番号 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 新大院博(医)甲第951号 |