The Value of Neuraminidase Inhibitors for the Prevention and Treatment of Seasonal Influenza: A Systematic Review of Systematic Reviews
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{"title"=>"The Value of Neuraminidase Inhibitors for the Prevention and Treatment of Seasonal Influenza: A Systematic Review of Systematic Reviews", "type"=>"generic", "authors"=>[{"first_name"=>"Barbara", "last_name"=>"Michiels", "scopus_author_id"=>"6603719518"}, {"first_name"=>"Karolien", "last_name"=>"van Puyenbroeck", "scopus_author_id"=>"35346176100"}, {"first_name"=>"Veronique", "last_name"=>"Verhoeven", "scopus_author_id"=>"6701706808"}, {"first_name"=>"Etienne", "last_name"=>"Vermeire", "scopus_author_id"=>"6602157030"}, {"first_name"=>"Samuel", "last_name"=>"Coenen", "scopus_author_id"=>"6701920264"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"23565231", "doi"=>"10.1371/journal.pone.0060348", "sgr"=>"84875648078", "isbn"=>"10.1371/journal.pone.0060348", "scopus"=>"2-s2.0-84875648078", "issn"=>"19326203", "pui"=>"368635047"}, "id"=>"eb55824d-cad3-366d-a56e-c8d1d2ca50d0", "abstract"=>"Controversy has arisen regarding the effectiveness of neuraminidase inhibitors (NIs), especially against influenza-related complications. A literature search was performed to critically assess the evidence collected by the available systematic reviews (SRs) regarding the benefits and disadvantages of NIs (oseltamivir, zanamivir) compared to placebos in healthy and at-risk individuals of all ages for prophylaxis and treatment of seasonal influenza. A SR was done using the Cochrane Database of Systematic Reviews, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects, and Medline (January 2006-July 2012). Two reviewers selected SRs based on randomized clinical trials, which were restricted to intention-to-treat results, and they assessed review (AMSTAR) and study quality indicators (GRADE). The SRs included (N = 9) were of high quality. The efficacy of NIs in prophylaxis ranged from 64% (16-85) to 92% (37-99); the absolute risk reduction ranged from 1.2% to 12.1% (GRADE moderate to low). Clinically relevant treatment benefits of NIs were small in healthy adults and children suffering from influenza-like illness (GRADE high to moderate). Oseltamivir reduced antibiotic usage in healthy adults according to one SR, but this was not confirmed by other reviews (GRADE low). Zanamivir showed a preventive effect on antibiotic usage in children (95% (77-99);GRADE moderate) and on the occurrence of bronchitis in at-risk individuals (59% (30-76);GRADE moderate). No evidence was available on the treatment benefits of NIs in elderly and at-risk groups and their effects on hospitalization and mortality. In oseltamivir trials, nausea, vomiting and diarrhea were significant side-effects. For zanamivir trials, no adverse effects have been reported. The combination of diagnostic uncertainty, the risk for virus strain resistance, possible side effects and financial cost outweigh the small benefits of oseltamivir or zanamivir for the prophylaxis and treatment of healthy individuals. No relevant benefits of these NIs on complications in at-risk individuals have been established.", "link"=>"http://www.mendeley.com/research/value-neuraminidase-inhibitors-prevention-treatment-seasonal-influenza-systematic-review-systematic-4", "reader_count"=>75, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>3, "Librarian"=>1, "Researcher"=>16, "Student > Doctoral Student"=>6, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>3, "Other"=>6, "Student > Master"=>12, "Student > Bachelor"=>17, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>3, "Librarian"=>1, "Researcher"=>16, "Student > Doctoral Student"=>6, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>3, "Other"=>6, "Student > Master"=>12, "Student > Bachelor"=>17, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Agricultural and Biological Sciences"=>15, "Arts and Humanities"=>1, "Veterinary Science and Veterinary Medicine"=>1, "Chemistry"=>3, "Computer Science"=>2, "Biochemistry, Genetics and Molecular Biology"=>3, "Nursing and Health Professions"=>2, "Medicine and Dentistry"=>28, "Pharmacology, Toxicology and Pharmaceutical Science"=>5, "Physics and Astronomy"=>1, "Psychology"=>2, "Social Sciences"=>2, "Immunology and Microbiology"=>4}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>28}, "Social Sciences"=>{"Social Sciences"=>2}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>2}, "Unspecified"=>{"Unspecified"=>6}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>5}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Chemistry"=>{"Chemistry"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>4}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>15}, "Computer Science"=>{"Computer Science"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>3}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "reader_count_by_country"=>{"Colombia"=>1, "Netherlands"=>1, "Argentina"=>1, "Belgium"=>1, "United States"=>1, "United Kingdom"=>3, "Chile"=>1, "Switzerland"=>1, "Spain"=>1, "India"=>2}, "group_count"=>3}

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/1008791"], "description"=>"<p>SR = systematic review; NA = not applicable.</p>", "links"=>[], "tags"=>["appraisal", "included"], "article_id"=>669415, "categories"=>["Pharmacology", "Infectious Diseases", "Immunology"], "users"=>["Barbara Michiels", "Karolien Van Puyenbroeck", "Veronique Verhoeven", "Etienne Vermeire", "Samuel Coenen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0060348.t003", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_AMSTAR_quality_appraisal_of_the_included_SRs_/669415", "title"=>"AMSTAR quality appraisal of the included SRs.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-02 02:36:55"}
  • {"files"=>["https://ndownloader.figshare.com/files/1008887"], "description"=>"a<p>O = 150 mg oseltamivir daily during 5 days in adults, elderly; dosage adjusted to weight in children.</p>b<p>Z = 2×10 mg inhaled zanamivir daily during 5 days in adults, elderly; dosage adjusted to weight in children.</p>c<p>difference in median hours in oseltamivir trials and difference in median days in zanamivir trials.</p>d<p>no pooling of results.</p>e<p>GRADE quality of evidence: high; moderate; low.</p><p>ITT = intention-to-treat; NI = neuraminidase inhibitor; CI = confidence interval.</p>", "links"=>[], "tags"=>["oseltamivir", "zanamivir", "placebo", "at-risk", "populations", "pooled"], "article_id"=>669510, "categories"=>["Pharmacology", "Infectious Diseases", "Immunology"], "users"=>["Barbara Michiels", "Karolien Van Puyenbroeck", "Veronique Verhoeven", "Etienne Vermeire", "Samuel Coenen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0060348.t005", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Treatment_effect_of_oseltamivir_and_zanamivir_versus_placebo_in_healthy_adults_children_elderly_and_at_risk_populations_ITT_8211_pooled_results_/669510", "title"=>"Treatment effect of oseltamivir and zanamivir versus placebo in healthy adults, children, elderly and at-risk populations (ITT – pooled results).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-02 02:38:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/1003541"], "description"=>"<div><p>Controversy has arisen regarding the effectiveness of neuraminidase inhibitors (NIs), especially against influenza-related complications. A literature search was performed to critically assess the evidence collected by the available systematic reviews (SRs) regarding the benefits and disadvantages of NIs (oseltamivir, zanamivir) compared to placebos in healthy and at-risk individuals of all ages for prophylaxis and treatment of seasonal influenza. A SR was done using the Cochrane Database of Systematic Reviews, Health Technology Assessment Database, Database of Abstracts of Reviews of Effects, and Medline (January 2006–July 2012). Two reviewers selected SRs based on randomized clinical trials, which were restricted to intention-to-treat results, and they assessed review (AMSTAR) and study quality indicators (GRADE). The SRs included (N = 9) were of high quality. The efficacy of NIs in prophylaxis ranged from 64% (16–85) to 92% (37–99); the absolute risk reduction ranged from 1.2% to 12.1% (GRADE moderate to low). Clinically relevant treatment benefits of NIs were small in healthy adults and children suffering from influenza-like illness (GRADE high to moderate). Oseltamivir reduced antibiotic usage in healthy adults according to one SR, but this was not confirmed by other reviews (GRADE low). Zanamivir showed a preventive effect on antibiotic usage in children (95% (77–99);GRADE moderate) and on the occurrence of bronchitis in at-risk individuals (59% (30–76);GRADE moderate). No evidence was available on the treatment benefits of NIs in elderly and at-risk groups and their effects on hospitalization and mortality. In oseltamivir trials, nausea, vomiting and diarrhea were significant side-effects. For zanamivir trials, no adverse effects have been reported. The combination of diagnostic uncertainty, the risk for virus strain resistance, possible side effects and financial cost outweigh the small benefits of oseltamivir or zanamivir for the prophylaxis and treatment of healthy individuals. No relevant benefits of these NIs on complications in at-risk individuals have been established.</p> </div>", "links"=>[], "tags"=>["neuraminidase", "inhibitors", "seasonal", "systematic"], "article_id"=>664386, "categories"=>["Pharmacology", "Infectious Diseases", "Immunology"], "users"=>["Barbara Michiels", "Karolien Van Puyenbroeck", "Veronique Verhoeven", "Etienne Vermeire", "Samuel Coenen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0060348", "stats"=>{"downloads"=>5, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Value_of_Neuraminidase_Inhibitors_for_the_Prevention_and_Treatment_of_Seasonal_Influenza_A_Systematic_Review_of_Systematic_Reviews_/664386", "title"=>"The Value of Neuraminidase Inhibitors for the Prevention and Treatment of Seasonal Influenza: A Systematic Review of Systematic Reviews", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-03 04:43:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1008868"], "description"=>"a<p>O = 150 mg oseltamivir daily during 5 days in adults, elderly; dosage adjusted to weight in children.</p>b<p>Z = 2×10 mg inhaled zanamivir daily during 5 days in adults, elderly; dosage adjusted to weight in children.</p>c<p>Estimate: odds ratio (Burch, Jefferson); risk difference (Wang).</p>d<p>no pooling of results.</p>e<p>GRADE quality of evidence: high; moderate; low.</p><p>ITT = intention-to-treat; NI = neuraminidase inhibitor; CI = confidence interval; GP = general practitioner.</p>", "links"=>[], "tags"=>["complications", "at-risk", "individuals", "treated", "oseltamivir", "zanamivir", "placebo", "systematic", "reviews", "pooled"], "article_id"=>669487, "categories"=>["Pharmacology", "Infectious Diseases", "Immunology"], "users"=>["Barbara Michiels", "Karolien Van Puyenbroeck", "Veronique Verhoeven", "Etienne Vermeire", "Samuel Coenen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0060348.t006", "stats"=>{"downloads"=>3, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_rate_of_complications_in_healthy_adults_children_elderly_and_at_risk_individuals_treated_with_oseltamivir_and_zanamivir_versus_placebo_according_to_different_systematic_reviews_ITT_8211_pooled_results_/669487", "title"=>"The rate of complications in healthy adults, children, elderly and at-risk individuals treated with oseltamivir and zanamivir versus placebo according to different systematic reviews (ITT – pooled results).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-02 02:38:07"}
  • {"files"=>["https://ndownloader.figshare.com/files/1008806"], "description"=>"<p>List of excluded reviews with reasons.</p>", "links"=>[], "tags"=>["excluded", "reviews"], "article_id"=>669433, "categories"=>["Pharmacology", "Infectious Diseases", "Immunology"], "users"=>["Barbara Michiels", "Karolien Van Puyenbroeck", "Veronique Verhoeven", "Etienne Vermeire", "Samuel Coenen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0060348.t002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_List_of_excluded_reviews_with_reasons_/669433", "title"=>"List of excluded reviews with reasons.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-04-02 02:37:13"}
  • {"files"=>["https://ndownloader.figshare.com/files/1003538"], "description"=>"<p>Flow of information for the search (PRISMA).</p>", "links"=>[], "tags"=>["immunology", "Infectious diseases", "pharmacology"], "article_id"=>664383, "categories"=>["Pharmacology", "Infectious Diseases", "Immunology"], "users"=>["Barbara Michiels", "Karolien Van Puyenbroeck", "Veronique Verhoeven", "Etienne Vermeire", "Samuel Coenen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0060348.g001", "stats"=>{"downloads"=>2, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_of_information_for_the_search_PRISMA_/664383", "title"=>"Flow of information for the search (PRISMA).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-04-03 04:43:29"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Immunology", "average_usage"=>[266, 466, 591, 701, 799, 887, 982, 1067, 1155, 1237, 1317, 1395, 1458]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[264, 460, 584, 692, 794, 887, 978, 1067, 1154, 1241, 1328, 1408, 1474]}, {"subject_area"=>"/Medicine and health sciences/Pediatrics", "average_usage"=>[248, 430, 563, 680, 778, 859, 949, 1017, 1115, 1199, 1281, 1364, 1431]}, {"subject_area"=>"/Medicine and health sciences/Pharmaceutics", "average_usage"=>[254, 457, 591, 700, 808, 906, 1001, 1093, 1185, 1276, 1373, 1457, 1535]}, {"subject_area"=>"/Medicine and health sciences/Public and occupational health", "average_usage"=>[291, 491, 610, 723, 817, 906, 991, 1071, 1153, 1238, 1324, 1411, 1478]}]}
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