Oral oseltamivir improves pulmonary function and reduces exacerbation frequency for influenza-infected children with
Sebastian L Johnston1, Fernando Ferrero, Maria Luz Garcia
1Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
Insights
Oseltamivir (Tamiflu) is safe for children with asthma and influenza. While it did not significantly shorten illness duration, it improved lung function and reduced asthma exacerbations.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Pharmacology
Background:
- Influenza in asthmatic children leads to higher hospitalization rates.
- Influenza vaccination has variable efficacy and low uptake in this population.
- Oseltamivir (Tamiflu) is effective against influenza strains and reduces illness severity in children and adults.
Purpose of the Study:
- To determine the effects of oseltamivir on influenza-infected children with asthma.
- To evaluate oseltamivir's impact on symptom duration, pulmonary function, and asthma exacerbations.
Main Methods:
- Randomized, placebo-controlled trial involving asthmatic children aged 6-12 years.
- Oseltamivir (2 mg/kg) or placebo administered twice daily as a syrup.
- Primary endpoint: time to freedom from illness; secondary endpoints: symptom severity, asthma exacerbations, and lung function (FEV1).
Main Results:
- The primary endpoint (time to freedom from illness) was not met, though trends suggested improvement.
- Significant improvement in forced expiratory volume at 1 second (FEV1) in the oseltamivir group (10.8% vs. 4.7%, P=0.0148).
- Fewer asthma exacerbations observed in oseltamivir-treated patients up to day 7 (51% vs. 68%, P=0.031).
Conclusions:
- Oseltamivir is safe and well-tolerated in influenza-infected children with asthma.
- Oseltamivir may improve lung function and reduce asthma exacerbations during influenza infection.
- Further research may be warranted to explore oseltamivir's benefits in this population.
Background:
Among asthmatic children, influenza is associated with increased hospitalizations. Although vaccination is safe and effective among asthmatic children, its protective efficacy varies and uptake rates can be low. In comparison, oseltamivir (Tamiflu) is effective against all influenza strains and can reduce the severity and duration of influenza among adults and children. This study determined the effects of oseltamivir among influenza-infected children with asthma.
Methods:
Asthmatic children (6-12 years of age) were randomized to receive oseltamivir (2 mg/kg) or placebo twice daily, as a syrup. The primary efficacy endpoint was the time to freedom from illness. Secondary endpoints included the area under the symptom score-hour curve, the proportion of patients with asthma exacerbations and changes in forced expiratory volume at 1 second during the dosing period. Analysis was performed for both the intent-to-treat infected (n = 179) and per protocol (n = 162) populations.
Results:
The primary endpoint for this study was not met. Oseltamivir tended to reduce the time to freedom from illness in the intent-to-treat infected population (10.4 hours, 8%; P = 0.5420), the per protocol population (24.3 hours, 17%; P = 0.1607) and patients who started treatment <24 hours after symptom onset (39.8 hours, 25%; P = 0.0780). However, an improvement in pulmonary function was observed. The improvement in forced expiratory volume at 1 second was significantly greater among oseltamivir-treated patients (10.8% versus 4.7%; P = 0.0148). Oseltamivir-treated patients also experienced fewer asthma exacerbations up to day 7 (68% versus 51%; P = 0.031). Oseltamivir was safe and well-tolerated.
Conclusions:
Oseltamivir is safe and well-tolerated among asthmatic children, may reduce symptom duration and helps improve lung function and reduce asthma exacerbations during influenza infection.
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