Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

dc.creatorMuthuri, Stella G
dc.creatorVenkatesan, Sudhir
dc.creatorMyles, Puja R
dc.creatorLeonardi-Bee, Jo
dc.creatorAl Khuwaitir, Tarig
dc.creatorAl Mamun, Adbullah
dc.creatorAnovadiya, Ashish P
dc.creatorAzziz-Baumgartner, Eduardo
dc.creatorBáez, Clarisa
dc.creatorBassetti, Matteo
dc.creatorBeovic, Bojana
dc.creatorBertisch, Barbara
dc.creatorBonmarin, Isabelle
dc.creatorBooy, Robert
dc.creatorBorja-Aburto, Victor H
dc.creatorBurgmann, Heinz
dc.creatorCao, Bin
dc.creatorCarratala, Jordi
dc.creatorDenholm, Justin T
dc.creatorDominguez, Samuel R
dc.creatorDuarte, Pericles A D
dc.creatorDubnov-Raz, Gal
dc.creatorEchavarria, Marcela
dc.creatorFanella, Sergio
dc.creatorGao, Zhancheng
dc.creatorGérardin, Patrick
dc.creatorGiannella, Maddalena
dc.creatorGubbels, Sophie
dc.creatorHerberg, Jethro
dc.creatorIglesias, Anjarath L Higuera
dc.creatorHoger, Peter H
dc.creatorHu, Xiaoyun
dc.creatorIslam, Quazi T
dc.creatorJiménez, Mirela F
dc.creatorKandeel, Amr
dc.creatorKeijzers, Gerben
dc.creatorKhalili, Hossein
dc.creatorKnight, Marian
dc.creatorKudo, Koichiro
dc.creatorKusznierz, Gabriela F.
dc.creatorKuzman, Ilija
dc.creatorKwan, Arthur M C
dc.creatorAmine, Idriss Lahlou
dc.creatorLangenegger, Eduard
dc.creatorLankarani, Kamran B
dc.creatorLeo, Yee-Sin
dc.creatorLinko, Rita
dc.creatorLiu, Pei
dc.creatorMadanat, Faris
dc.creatorMayo-Montero, Elga
dc.creatorMcGeer, Allison
dc.creatorMemish, Ziad A
dc.creatorMetan, Gokhan
dc.creatorMickiene, Auksė
dc.creatorMikić, Dragan
dc.creatorMohn, Kristin G I
dc.creatorMoradi, Ahmadreza
dc.creatorNymadawa, Pagbajabyn
dc.creatorOliva, Maria E
dc.creatorOzkan, Mehpare
dc.creatorParekh, Dhruv
dc.creatorPaul, Mical
dc.creatorPolack, Fernando P.
dc.creatorRath, Barbara A
dc.creatorRodríguez, Alejandro H
dc.creatorSarrouf, Elena B
dc.creatorSeale, Anna C
dc.creatorSertogullarindan, Bunyamin
dc.creatorSiqueira, Marilda M
dc.creatorSkręt-Magierło, Joanna
dc.creatorStephan, Frank
dc.creatorTalarek, Ewa
dc.creatorTang, Julian W
dc.creatorTo, Kelvin K W
dc.creatorTorres, Antoni
dc.creatorTörün, Selda H
dc.creatorTran, Dat
dc.creatorUyeki, Timothy M
dc.creatorvan Zwol, Annelies
dc.creatorVaudry, Wendy
dc.creatorVidmar, Tjasa
dc.creatorYokota, Renata T C
dc.creatorZarogoulidis, Paul
dc.creatorNguyen-Van-Tam, Jonathan S
dc.date2019-11-27T19:34:35Z
dc.date2019-11-27T19:34:35Z
dc.date2014-05
dc.date.accessioned2023-08-29T20:06:16Z
dc.date.available2023-08-29T20:06:16Z
dc.identifierhttp://sgc.anlis.gob.ar/handle/123456789/1389
dc.identifier10.1016/S2213-2600(14)70041-4
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8519054
dc.descriptionBACKGROUND: Neuraminidase inhibitors were widely used during the 2009-10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. METHODS: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. FINDINGS: We included data for 29,234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70-0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41-0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37-0·67; p<0·0001). These associations with reduced mortality risk were less pronounced and not significant in children. There was an increase in the mortality hazard rate with each day's delay in initiation of treatment up to day 5 as compared with treatment initiated within 2 days of symptom onset (adjusted hazard ratio [HR 1·23] [95% CI 1·18-1·28]; p<0·0001 for the increasing HR with each day's delay). INTERPRETATION: We advocate early instigation of neuraminidase inhibitor treatment in adults admitted to hospital with suspected or proven influenza infection. FUNDING: F Hoffmann-La Roche.
dc.languageen
dc.relationThe Lancet. Respiratory medicine
dc.rightsopen
dc.titleEffectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data
dc.typeArtículo


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