Journal article
Comparative effectiveness of combined favipiravir and oseltamivir therapy versus oseltamivir monotherapy in critically ill patients with influenza virus infection
- Abstract:
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Background A synergistic effect of combination therapy with favipiravir and oseltamivir has been reported in preclinical models of influenza. However, no data are available on the clinical effectiveness of combination therapy in severe influenza.
Methods Data from 2 separate prospective studies of influenza adults were used to compare outcomes between combination and oseltamivir monotherapy. Outcomes included rate of clinical improvement (defined as a decrease of 2 categories on a 7-category ordinal scale) and viral RNA detectability over time. Subhazard ratios (sHRs) were estimated by the Fine and Gray model for competing risks.
Results In total, 40 patients were treated with combination therapy and 128 with oseltamivir alone. Clinical improvement on day 14 in the combination group was higher than in the monotherapy group (62.5% vs 42.2%; P = .0247). The adjusted sHR for combination therapy was 2.06 (95% confidence interval, 1.30–3.26). The proportion of undetectable viral RNA at day 10 was higher in the combination group than the oseltamivir group (67.5% vs 21.9%; P < .01). No significant differences were observed in mortality or other outcomes.
Conclusions Favipiravir and oseltamivir combination therapy may accelerate clinical recovery compared to oseltamivir monotherapy in severe influenza, and this strategy should be formally evaluated in a randomized controlled trial.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 185.8KB, Terms of use)
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- Publisher copy:
- 10.1093/infdis/jiz656
Authors
- Publisher:
- Oxford University Press
- Journal:
- Journal of Infectious Diseases More from this journal
- Volume:
- 221
- Issue:
- 10
- Pages:
- 1688–1698
- Publication date:
- 2019-12-11
- Acceptance date:
- 2019-12-10
- DOI:
- EISSN:
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1537-6613
- ISSN:
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0022-1899
- Pmid:
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31822885
- Language:
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English
- Keywords:
- Pubs id:
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pubs:1077500
- UUID:
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uuid:6d72b63d-f5bf-487f-ac13-666f2fbe0876
- Local pid:
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pubs:1077500
- Source identifiers:
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1077500
- Deposit date:
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2019-12-16
Terms of use
- Copyright holder:
- Wang et al
- Copyright date:
- 2019
- Rights statement:
- © The Authors 2019. Published by Oxford University Press for the Infectious Diseases Society of America
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Oxford University Press at https://doi.org/10.1093/infdis/jiz656
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