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Open Forum Infect Dis. 2017 Jun 19;4(3):ofx129. doi: 10.1093/ofid/ofx129. eCollection 2017 Summer.

Efficacy and Safety of Intravenous Peramivir Compared With Oseltamivir in High-Risk Patients Infected With Influenza A and B Viruses: A Multicenter Randomized Controlled Study.

Author information

1
Department of Respiratory Diseases, Nagasaki University Hospital.
2
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan.
3
Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences.
4
Department of Infection Control Science, Graduate School of Medicine, Osaka City University.
5
Medical Affairs, Shionogi & Co, Ltd, Osaka.
6
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, and.

Abstract

BACKGROUND:

Clinical studies comparing the different neuraminidase inhibitors for treatment of at-risk patients with influenza have not been performed. To optimize such treatments, we assessed the efficacy and safety of intravenous peramivir compared with oral oseltamivir in treating seasonal influenza A or B virus infection.

METHODS:

A multicenter, randomized, controlled clinical trial was conducted from December 2012 to May 2014 in high-risk patients infected with seasonal influenza. A total of 92 adult inpatients and outpatients with high risk factors (HRFs) were treated by either a single intravenous infusion of peramivir (600 mg) or oral administration of oseltamivir (75 mg, twice per day for 5 days).

RESULTS:

The median times to clinical stability (time to reach <37°C) were 40.0 hours (95% confidence interval [CI] = 23.3-64.5) and 37.8 hours (95% CI = 26.3-45.3) in the peramivir and oseltamivir groups, respectively; these values did not reveal a significant difference. The virus titer and change of mean total symptom scores decreased similarly with both treatments. Results of step-wise regression suggested that virus type was a significantly effective prognostic factor with respect to illness resolution. Adverse events (AEs) with peramivir and oseltamivir occurred in 2.2% (n = 1/46) and 13.0% (n = 6/46) of patients, respectively. The severity of AEs was mild in all cases except 2 patients who showed pneumonia or COPD aggravation; both were in the oseltamivir group.

CONCLUSIONS:

Intravenous peramivir was effective based on the result of direct comparison with oral oseltamivir. Thus our data show that peramivir is a useful option for the treatment of influenza-infected patients with HRFs.

KEYWORDS:

high-risk patient; influenza; neuraminidase inhibitor; oseltamivir; peramivir

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