A systematic review and meta-analysis conducted by Shandong University, China, has shed light on the efficacy and safety of antiviral medications for treating nonsevere influenza. The study, published in JAMA Internal Medicine, highlights that baloxavir (Xofluza) may reduce hospital admission risks for high-risk patients and shorten symptom duration without increasing adverse events.
Key Findings:
- Baloxavir Benefits: Baloxavir likely shortens symptom duration by an average of 1.02 days (moderate certainty) and may lower hospital admission risks for high-risk patients (low certainty). It also showed fewer adverse events compared to placebo (high certainty). However, there is a 10% risk of resistance emergence (low certainty).
- Oseltamivir (Tamiflu): This commonly used antiviral showed minimal impact on reducing mortality or hospitalization risks for both low- and high-risk groups (high certainty). Symptom reduction averaged 0.75 days (moderate certainty), but it was associated with a higher risk of adverse events (moderate certainty).
- Other Antivirals: Medications such as zanamivir (Relenza), laninamivir, and umifenovir demonstrated inconsistent effects on outcomes, with evidence quality ranging from moderate to very low. Hospitalization data for peramivir and amantadine were unavailable.
Study Details: The meta-analysis reviewed 73 randomized clinical trials from 1971 to 2023, encompassing 34,332 participants. Data sources included major medical databases like MEDLINE and Embase, with paired reviewers conducting independent evaluations. Outcomes analyzed included mortality, hospitalization, symptom alleviation, and adverse events. The certainty of evidence was assessed using the GRADE framework.
Implications for Treatment: Baloxavir emerged as a promising antiviral option, particularly for high-risk patients with nonsevere influenza. It demonstrated potential advantages in reducing hospitalization risks and shortening symptom duration without significant treatment-related adverse events. In contrast, oseltamivir showed limited effectiveness in alleviating symptoms and was associated with a higher risk of adverse effects.
Evidence Gaps: The study identified gaps in data, particularly concerning ICU admissions, hospitalization duration, and antiviral resistance. Researchers emphasized the need for further studies focusing on specific patient outcomes to refine treatment strategies.
Influenza, a viral respiratory illness, affects millions annually, posing severe risks, especially to vulnerable populations. As reported by medicalxpress, The study underscores the importance of tailored antiviral therapies to improve outcomes and reduce complications.