PMID- 35315516
OWN - NLM
STAT- MEDLINE
DCOM- 20230815
LR  - 20230815
IS  - 1096-9071 (Electronic)
IS  - 0146-6615 (Linking)
VI  - 94
IP  - 7
DP  - 2022 Jul
TI  - Efficacy and safety of single-dose antiviral drugs for influenza treatment: A 
      systematic review and network meta-analysis.
PG  - 3270-3302
LID - 10.1002/jmv.27729 [doi]
AB  - To conduct network meta-analysis (NMA) of clinical efficacy and safety of 
      single-dose antiviral drugs, grouped by dosage, in treatment of influenza. 
      Systematic retrievals were conducted in databases, including Pubmed, Embase, Web 
      of Science, the Cochrane Register of Clinical Trials and from the website 
      ClinicalTrials.gov, for clinical trials recorded between the interception of the 
      databases and March 31, 2021. Randomized controlled trials (RCTs) of influenza 
      treatment in which single-dose antiviral drugs were administered were selected 
      according to preset inclusion and exclusion criteria by two researchers who 
      screened the literature independently from each other. The quality of the 
      included studies was assessed using the Cochrane bias risk assessment tool. 
      Software such as Stata 16.0 and Review Manager 5.3 was adopted for statistical 
      analysis. Pairwise meta-analysis and NMA were carried out under the 
      random-effects model. For both binary and continuous variables, odds ratio (OR), 
      mean difference (MD) and their 95% confidence intervals (CI) were used to rank 
      treatment efficiencies and analyze the differences. A total of 12 RCTs involving 
      7296 participants were included in the analysis. According to the NMA results, 
      peramivir 300 mg (MD = -17.68, 95% CI: [-34.05, -1.32]), peramivir 600 mg 
      (MD = -16.15, 95% CI: [-29.35, -2.95]), baloxavir (MD = -14.67, 95% CI: [-26.75, 
      -2.58]) and laninamivir 40 mg (MD = -12.42, 95% CI: [-22.53, -2.31]) remarkably 
      outperformed laninamivir 20 mg in time to alleviation of symptoms (TTAS). 
      However, no intervention statistically outperform others in antipyretic time, 
      virus titer variations against the baseline 24 and 48 h after medication and 
      adverse events (AEs). The efficacy rankings were: peramivir 300 mg (the surface 
      under the cumulative ranking curve [SUCRA] = 80.3%) > peramivir 600 mg 
      (SUCRA = 76.2%) > baloxavir (SUCRA = 68.4%) > laninamivir 40 mg 
      (SUCRA = 55.0%) > laninamivir 20 mg (SUCRA = 16.6%) for TTAS; baloxavir 
      (SUCRA = 76.3%) > peramivir 600 mg (SUCRA = 67.8%) > laninamivir 40 mg 
      (SUCRA = 47.2%) > laninamivir 20 mg (SUCRA = 40.0%) for antipyretic time; 
      baloxavir (SUCRA = 96.7%) > peramivir 300 mg (SUCRA = 64.5%)  approximately  peramivir 600 mg 
      (SUCRA = 63.2%), baloxavir (SUCRA = 93.2%) > peramivir 600 mg 
      (SUCRA = 64.0%)  approximately  peramivir 300 mg (SUCRA = 55.0%), for virus titer variations 
      against the baseline 24 and 48 h after medication, respectively; and baloxavir 
      (SUCRA = 83.4%) > peramivir 300 mg (SUCRA = 71.4%) > laninamivir 20 mg 
      (SUCRA = 62.4%) > peramivir 600 mg (SUCRA = 56.2%) > laninamivir 40 mg 
      (SUCRA = 36.8%) for adverse events. Among the single-dose anti-influenza virus 
      drugs compared, peramivir is superior to baloxavir and laninamivir in TTAS, 
      whereas baloxavir has the best efficacy in antipyretic time, virus titer 
      variations against the baseline 24 and 48 h after medication and AEs. This study 
      has been registered in the International Prospective Register of Systematic 
      Reviews (PROSPERO), with a registration number of CRD42021238220.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Zhao, Yonghong
AU  - Zhao Y
AUID- ORCID: 0000-0001-9537-4133
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Huang, Guangliang
AU  - Huang G
AUID- ORCID: 0000-0003-3520-2609
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - He, Wenjuan
AU  - He W
AUID- ORCID: 0000-0002-0228-9317
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Sun, Qian
AU  - Sun Q
AUID- ORCID: 0000-0003-1831-1715
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Zhao, Xiaojuan
AU  - Zhao X
AUID- ORCID: 0000-0002-4350-2022
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Li, Dan
AU  - Li D
AUID- ORCID: 0000-0002-5723-9886
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Wang, Huichao
AU  - Wang H
AUID- ORCID: 0000-0002-0858-4229
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Cui, Wenyan
AU  - Cui W
AUID- ORCID: 0000-0002-0949-0005
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
FAU - Liu, Xiuju
AU  - Liu X
AUID- ORCID: 0000-0002-2809-2491
AD  - The Second Hospital of HeBei Medical University, Shijiazhuang, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20220404
PL  - United States
TA  - J Med Virol
JT  - Journal of medical virology
JID - 7705876
RN  - 0 (Antipyretics)
RN  - 0 (Antiviral Agents)
SB  - IM
MH  - Humans
MH  - *Antipyretics/therapeutic use
MH  - Antiviral Agents/adverse effects
MH  - *Influenza, Human/drug therapy
MH  - Network Meta-Analysis
OTO - NOTNLM
OT  - antiviral drugs
OT  - efficacy
OT  - influenza
OT  - network meta-analysis
OT  - safety
EDAT- 2022/03/23 06:00
MHDA- 2022/05/21 06:00
CRDT- 2022/03/22 08:59
PHST- 2022/03/01 00:00 [revised]
PHST- 2021/12/20 00:00 [received]
PHST- 2022/03/18 00:00 [accepted]
PHST- 2022/03/23 06:00 [pubmed]
PHST- 2022/05/21 06:00 [medline]
PHST- 2022/03/22 08:59 [entrez]
AID - 10.1002/jmv.27729 [doi]
PST - ppublish
SO  - J Med Virol. 2022 Jul;94(7):3270-3302. doi: 10.1002/jmv.27729. Epub 2022 Apr 4.