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Factors associated with non-persistence to oral and inhaled antiviral therapies for seasonal influenza: a secondary analysis of a double-blind, multicentre, randomised clinical trial.


ABSTRACT: OBJECTIVES:We aimed to evaluate and compare non-adherence to oral and inhaled antiviral therapies prescribed of a randomised clinical trial in outpatients with influenza A infection. DESIGN:A parallel, three-arm, double-blinded trial randomly allocated antiviral therapies twice daily for 5?days: (1) oral oseltamivir plus inhaled zanamivir (arm OZ); (2) oseltamivir plus inhaled placebo (arm Opz); or (3) oral placebo plus inhaled zanamivir (arm poZ). Analysis of non-adherence was a secondary objective of the trial. SETTINGS:Outpatients were enrolled by 145 general practitioners throughout France during the 2008-2009 seasonal influenza epidemics. PARTICIPANTS:A total of 541 adults presenting with influenza-like illness for less than 36?hours. PRIMARY OUTCOMES:Non-persistence, the time between inclusion and the last dose treated as a failure time, was used as the primary endpoint. RESULTS:The proportions of patients who persisted on treatment until the end of prescription were estimated at 85.73% (±3.28%) for the oral route and 82.73% (±3.44%) for the inhaled route. Based on multivariable models, non-persistence was associated with a PCR confirmation of influenza for both the oral (HR=0.54, p=0.010) and inhaled (HR=0.59, p=0.018) drugs and antibiotic coprescriptions (HR=2.07, p=0.007; and HR=1.88, p=0.017, respectively) and active combination treatment (HR=1.71, p=0.035; and HR=1.58, p=0.035, respectively). The hazard of non-persistence of the inhaled therapy was increased compared with that of the oral therapy (HR=1.23, p=0.043). CONCLUSION:In addition to the clinical and virological profiles of influenza infection, non-persistence may have been influenced by an active combination and the route of administration. RCT REGISTRATION NUMBER:NCT00799760. This is a post-result analysis.

SUBMITTER: Flicoteaux R 

PROVIDER: S-EPMC5734282 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Factors associated with non-persistence to oral and inhaled antiviral therapies for seasonal influenza: a secondary analysis of a double-blind, multicentre, randomised clinical trial.

Flicoteaux Remi R   Protopopescu Camelia C   Tibi Annick A   Blanchon Thierry T   Werf Sylvie Van Der SV   Duval Xavier X   Mosnier Anne A   Charlois-Ou Cécile C   Lina Bruno B   Leport Catherine C   Chevret Sylvie S  

BMJ open 20170710 7


<h4>Objectives</h4>We aimed to evaluate and compare non-adherence to oral and inhaled antiviral therapies prescribed of a randomised clinical trial in outpatients with influenza A infection.<h4>Design</h4>A parallel, three-arm, double-blinded trial randomly allocated antiviral therapies twice daily for 5 days: (1) oral oseltamivir plus inhaled zanamivir (arm OZ); (2) oseltamivir plus inhaled placebo (arm Opz); or (3) oral placebo plus inhaled zanamivir (arm poZ). Analysis of non-adherence was a  ...[more]

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