Inhaled zanamivir noninferior to oral oseltamivir in preventing severe flu outcomes
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Inhaled zanamivir was noninferior to oral oseltamivir in preventing severe influenza-related outcomes in a study of more than 865,000 outpatients in Taiwan, researchers reported in Clinical Infectious Diseases.
“Individual patient data meta-analyses of randomized controlled trials show that early oseltamivir treatment for influenza cut risk of pneumonia and hospitalization by 44% and 63%, respectively,” Chia-Ping Su, PhD, medical officer at the Taiwan Centers for Disease Control, and colleagues wrote. “However, data are lacking for inhaled zanamivir on its effectiveness to prevent hospitalization and death.”
The large study enrolled 865,032 outpatients treated with inhaled zanamivir (n = 595,897) or oral oseltamivir (269,135) within 48 hours of being diagnosed with influenza. According to the study, the main outcome was influenza-related hospitalization or death within 14 days, which researchers determined by using Taiwan national health insurance database and national death registry, respectively.
Su and colleagues calculated that risk for developing hospitalization or death within 14 days did not differ between the two arms of the study (adjusted HR = 1.01; 95% CI, 0.96-1.06).
Additional analysis on high-risk subgroups also showed that inhaled zanamivir was noninferior to oral oseltamivir among patients aged older than 65 years (aHR = 1.14; 95% CI, 1.05-1.25) and patients with chronic lung diseases (aHR = 1.23; 95% CI, 1.08-1.41).
Based on the findings, the researchers concluded that for patients whose conditions do not require hospitalization within 2 days, “inhaled zanamivir is not inferior to oral oseltamivir as outpatient treatment to prevent influenza-related hospitalization or death.”
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Su CP, et al. Clin Infect Dis. 2022;doi:10.1093/cid/ciac217.
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