Antivirals for influenza: a summary of a systematic review and meta-analysis of observational studies
Por:
Santesso, N, Hsu, J, Mustafa, R, Brozek, J, Chen, YL, Hopkins, JP, Cheung, A, Hovhannisyan, G, Ivanova, L, Flottorp, SA, Saeterdal, I, Wong, AD, Tian, JH, Uyeki, TM, Akl, EA, Alonso-Coello, P, Smaill, F, Schunemann, HJ
Publicada:
1 sep 2013
Resumen:
Despite the use of antivirals to treat patients with severe influenza, questions remain with respect to effects and safety. Although a recent systematic review has provided some indication of benefit, the analysis is limited by the quality of the available evidence from randomized controlled trials. To supplement the existing information, the authors conducted a systematic review of observational studies of antiviral treatment for influenza. This report summarises the findings of that review. Similar to the randomised trials, the confidence in the estimates of the effects for decision-making is low to very low primarily due to the risk of selection and publication bias in the observational studies. From these observational studies, the summary estimates suggest that oseltamivir may reduce mortality, hospitalisation and duration of symptoms compared with no treatment. Inhaled zanamivir may also reduce symptom duration and hospitalisations, but patients may experience more complications compared with no treatment. Earlier treatment with antivirals is generally associated with better outcomes than later treatment. Further high-quality evidence is needed to inform treatment guidelines because of the overall low to very low quality of evidence.
Filiaciones:
Santesso, N:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Hsu, J:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Mustafa, R:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Brozek, J:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Chen, YL:
Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou 730000, Peoples R China
Hopkins, JP:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Niagara Reg Publ Hlth, Thorold, ON, Canada
Cheung, A:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Hovhannisyan, G:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Ivanova, L:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
Flottorp, SA:
Norwegian Knowledge Ctr Hlth Serv, Oslo, Norway
Univ Bergen, Dept Publ Hlth & Primary Hlth Care, Bergen, Norway
Saeterdal, I:
Norwegian Knowledge Ctr Hlth Serv, Oslo, Norway
Wong, AD:
McMaster Univ, Michael G DeGroote Sch Med, Hamilton, ON L8N 3Z5, Canada
Tian, JH:
Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou 730000, Peoples R China
Uyeki, TM:
Ctr Dis Control & Prevent, Influenza Div, Atlanta, GA USA
Akl, EA:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA
Alonso-Coello, P:
CIBERESP IIB St Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Smaill, F:
McMaster Univ, Dept Pathol & Mol Med, Hamilton, ON L8N 3Z5, Canada
Schunemann, HJ:
McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
McMaster Univ, Dept Med, Hamilton, ON L8N 3Z5, Canada
Green Published, Bronze
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