Use of Neuraminidase Inhibitors for Rapid Containment of Influenza: A Systematic Review and Meta-Analysis of Individual and Household Transmission Studies
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{"title"=>"Use of neuraminidase inhibitors for rapid containment of influenza: A systematic review and meta-analysis of individual and household transmission studies", "type"=>"generic", "authors"=>[{"first_name"=>"George N.", "last_name"=>"Okoli", "scopus_author_id"=>"55968085600"}, {"first_name"=>"Harmony E.", "last_name"=>"Otete", "scopus_author_id"=>"56436673000"}, {"first_name"=>"Charles R.", "last_name"=>"Beck", "scopus_author_id"=>"54787392500"}, {"first_name"=>"Jonathan S.", "last_name"=>"Nguyen-Van-Tam", "scopus_author_id"=>"7003371567"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84916910215", "pui"=>"600717250", "doi"=>"10.1371/journal.pone.0113633", "issn"=>"19326203", "pmid"=>"25490762", "sgr"=>"84916910215"}, "id"=>"85d70049-e3a7-31f5-ad76-ab73773021b3", "abstract"=>"OBJECTIVES: To assess the effectiveness of neuraminidase inhibitors for use in rapid containment of influenza. METHOD: We conducted a systematic review and meta-analysis in accordance with the PRISMA statement. Healthcare databases and sources of grey literature were searched up to 2012 and records screened against protocol eligibility criteria. Data extraction and risk of bias assessments were performed using a piloted form. Results were synthesised narratively and we undertook meta-analyses to calculate pooled estimates of effect, statistical heterogeneity and assessed publication bias. FINDINGS: Nine randomised controlled trials (RCTs) and eight observational studies met the inclusion criteria. Neuraminidase inhibitors provided 67 to 89% protection for individuals following prophylaxis. Meta-analysis of individual protection showed a significantly lower pooled odds of laboratory confirmed seasonal or influenza A(H1N1)pdm09 infection following oseltamivir usage compared to placebo or no therapy (n = 8 studies; odds ratio (OR) = 0.11; 95% confidence interval (CI) = 0.06 to 0.20; p<0.001; I2 = 58.7%). This result was comparable to the pooled odds ratio for individual protection with zanamivir (OR = 0.23; 95% CI 0.16 to 0.35). Similar point estimates were obtained with widely overlapping 95% CIs for household protection with oseltamivir or zanamivir. We found no studies of neuraminidase inhibitors to prevent population-wide community transmission of influenza. CONCLUSION: Oseltamivir and zanamivir are effective for prophylaxis of individuals and households irrespective of treatment of the index case. There are no data which directly support an effect on wider community transmission. PROTOCOL REGISTRY: PROSPERO registration number: CRD42013003880.", "link"=>"http://www.mendeley.com/research/neuraminidase-inhibitors-rapid-containment-influenza-systematic-review-metaanalysis-individual-house", "reader_count"=>20, "reader_count_by_academic_status"=>{"Researcher"=>7, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>3, "Student > Master"=>2, "Other"=>2, "Student > Bachelor"=>1, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Researcher"=>7, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>3, "Student > Master"=>2, "Other"=>2, "Student > Bachelor"=>1, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Medicine and Dentistry"=>14, "Agricultural and Biological Sciences"=>1, "Psychology"=>1, "Social Sciences"=>1, "Computer Science"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>14}, "Social Sciences"=>{"Social Sciences"=>1}, "Psychology"=>{"Psychology"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "reader_count_by_country"=>{"United States"=>1}, "group_count"=>1}

Scopus | Further Information

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/1831251"], "description"=>"<p><b>✓</b> Denotes a score of 1 (domain assessment was satisfactory), <b>✗</b> denotes no score (domain assessment was not satisfactory).</p><p>Risk of bias assessment for observational studies (n = 3) excluding prospective cohort studies) using Newcastle Ottawa Quality Assessment Scale.</p>", "links"=>[], "tags"=>["publication bias.FindingsNine randomised", "zanamivir", "individual", "crd", "neuraminidase", "prisma", "protection", "community transmission.Protocol RegistryPROSPERO registration number", "odds ratio", "ci", "rct", "household", "prophylaxi", "neuraminidase inhibitors", "oseltamivir", "data", "Household Transmission Studies ObjectivesTo", "protocol eligibility criteria"], "article_id"=>1265684, "categories"=>["Biological Sciences"], "users"=>["George N. Okoli", "Harmony E. Otete", "Charles R. Beck", "Jonathan S. Nguyen-Van-Tam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113633.t002", "stats"=>{"downloads"=>6, "page_views"=>32, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_of_bias_assessment_for_observational_studies_n_8202_8202_3_excluding_prospective_cohort_studies_using_Newcastle_Ottawa_Quality_Assessment_Scale_/1265684", "title"=>"Risk of bias assessment for observational studies (n = 3) excluding prospective cohort studies) using Newcastle Ottawa Quality Assessment Scale.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-12-09 02:47:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/1831217"], "description"=>"<p>CENTRAL = Cochrane Central Register of Controlled Trials; CDSR = Cochrane Database of Systematic Reviews; DARE = Database of Abstracts of Reviews; NHS = National Health Services; HTA = Health Technology Assessment; WHO Global Medical Index = World Health Organization Global Medical Index; OpenSIGLE = System for information on Grey Literature in Europe; CDC = Centers for Diseases Control and Prevention; IFPMA = International Federation of Pharmaceutical Manufacturers Associations.</p>", "links"=>[], "tags"=>["publication bias.FindingsNine randomised", "zanamivir", "individual", "crd", "neuraminidase", "prisma", "protection", "community transmission.Protocol RegistryPROSPERO registration number", "odds ratio", "ci", "rct", "household", "prophylaxi", "neuraminidase inhibitors", "oseltamivir", "data", "Household Transmission Studies ObjectivesTo", "protocol eligibility criteria"], "article_id"=>1265660, "categories"=>["Biological Sciences"], "users"=>["George N. Okoli", "Harmony E. Otete", "Charles R. Beck", "Jonathan S. Nguyen-Van-Tam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113633.g001", "stats"=>{"downloads"=>4, "page_views"=>271, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_the_literature_search_and_sifting_process_PRISMA_flow_diagram_/1265660", "title"=>"Summary of the literature search and sifting process (PRISMA flow diagram).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-12-09 02:47:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/1831262", "https://ndownloader.figshare.com/files/1831263", "https://ndownloader.figshare.com/files/1831264", "https://ndownloader.figshare.com/files/1831265", "https://ndownloader.figshare.com/files/1831266", "https://ndownloader.figshare.com/files/1831267"], "description"=>"<div><p>Objectives</p><p>To assess the effectiveness of neuraminidase inhibitors for use in rapid containment of influenza.</p><p>Method</p><p>We conducted a systematic review and meta-analysis in accordance with the PRISMA statement. Healthcare databases and sources of grey literature were searched up to 2012 and records screened against protocol eligibility criteria. Data extraction and risk of bias assessments were performed using a piloted form. Results were synthesised narratively and we undertook meta-analyses to calculate pooled estimates of effect, statistical heterogeneity and assessed publication bias.</p><p>Findings</p><p>Nine randomised controlled trials (RCTs) and eight observational studies met the inclusion criteria. Neuraminidase inhibitors provided 67 to 89% protection for individuals following prophylaxis. Meta-analysis of individual protection showed a significantly lower pooled odds of laboratory confirmed seasonal or influenza A(H1N1)pdm09 infection following oseltamivir usage compared to placebo or no therapy (n = 8 studies; odds ratio (OR) = 0.11; 95% confidence interval (CI) = 0.06 to 0.20; p<0.001; I<sup>2</sup> = 58.7%). This result was comparable to the pooled odds ratio for individual protection with zanamivir (OR = 0.23; 95% CI 0.16 to 0.35). Similar point estimates were obtained with widely overlapping 95% CIs for household protection with oseltamivir or zanamivir. We found no studies of neuraminidase inhibitors to prevent population-wide community transmission of influenza.</p><p>Conclusion</p><p>Oseltamivir and zanamivir are effective for prophylaxis of individuals and households irrespective of treatment of the index case. There are no data which directly support an effect on wider community transmission.</p><p>Protocol Registry</p><p>PROSPERO registration number: CRD42013003880</p></div>", "links"=>[], "tags"=>["publication bias.FindingsNine randomised", "zanamivir", "individual", "crd", "neuraminidase", "prisma", "protection", "community transmission.Protocol RegistryPROSPERO registration number", "odds ratio", "ci", "rct", "household", "prophylaxi", "neuraminidase inhibitors", "oseltamivir", "data", "Household Transmission Studies ObjectivesTo", "protocol eligibility criteria"], "article_id"=>1265693, "categories"=>["Biological Sciences"], "users"=>["George N. Okoli", "Harmony E. Otete", "Charles R. Beck", "Jonathan S. Nguyen-Van-Tam"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0113633.s001", "https://dx.doi.org/10.1371/journal.pone.0113633.s002", "https://dx.doi.org/10.1371/journal.pone.0113633.s003", "https://dx.doi.org/10.1371/journal.pone.0113633.s004", "https://dx.doi.org/10.1371/journal.pone.0113633.s005", "https://dx.doi.org/10.1371/journal.pone.0113633.s006"], "stats"=>{"downloads"=>30, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Use_of_Neuraminidase_Inhibitors_for_Rapid_Containment_of_Influenza_A_Systematic_Review_and_Meta_Analysis_of_Individual_and_Household_Transmission_Studies_/1265693", "title"=>"Use of Neuraminidase Inhibitors for Rapid Containment of Influenza: A Systematic Review and Meta-Analysis of Individual and Household Transmission Studies", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-12-09 02:47:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/1831220"], "description"=>"<p>Upper panel: RCTs and prospective cohort studies (n = 14); Lower panel: RCTs only (n = 9).</p>", "links"=>[], "tags"=>["publication bias.FindingsNine randomised", "zanamivir", "individual", "crd", "neuraminidase", "prisma", "protection", "community transmission.Protocol RegistryPROSPERO registration number", "odds ratio", "ci", "rct", "household", "prophylaxi", "neuraminidase inhibitors", "oseltamivir", "data", "Household Transmission Studies ObjectivesTo", "protocol eligibility criteria"], "article_id"=>1265663, "categories"=>["Biological Sciences"], "users"=>["George N. Okoli", "Harmony E. Otete", "Charles R. Beck", "Jonathan S. Nguyen-Van-Tam"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113633.g002", "stats"=>{"downloads"=>7, "page_views"=>118, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_of_bias_assessment_using_the_Cochrane_Collaboration_tool_/1265663", "title"=>"Risk of bias assessment using the Cochrane Collaboration tool.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-12-09 02:47:27"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Biochemistry", "average_usage"=>[282]}, {"subject_area"=>"/Biology and life sciences/Immunology", "average_usage"=>[293]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[285]}, {"subject_area"=>"/Medicine and health sciences/Immunology", "average_usage"=>[289]}, {"subject_area"=>"/Medicine and health sciences/Public and occupational health", "average_usage"=>[327, 510]}, {"subject_area"=>"/Physical sciences", "average_usage"=>[271]}, {"subject_area"=>"/Physical sciences/Mathematics", "average_usage"=>[286]}]}
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