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Inquiry into some gap among oseltamivir use and severe abnormal behavior in Japanese children and adolescents with

Yasushi Ohkusa1, Tamie Sugawara1, Kiyosu Taniguchi2

  • 1Infectious Disease Surveillance Center, National Institute of Infectious Diseases.

Drug Discoveries & Therapeutics
|January 25, 2019
PubMed

Insights

Oseltamivir may increase the risk of A-type abnormal behavior in children with influenza. However, other neuraminidase inhibitors (NI) or no NI also showed higher risks in our study.

Area of Science:

  • Pediatric Infectious Diseases
  • Neuroscience
  • Pharmacovigilance

Background:

  • Influenza treatment in children often involves neuraminidase inhibitors (NI).
  • Concerns exist regarding potential adverse effects, including abnormal behavior, associated with NI use.
  • Previous studies have yielded conflicting results on the association between specific NI and abnormal behavior.

Purpose of the Study:

  • To compare the risk of severe abnormal behavior in pediatric influenza patients treated with different neuraminidase inhibitors (NI).
  • To investigate the association between oseltamivir, peramivir, zanamivir, laninamivir, and severe abnormal behavior.
  • To establish a more clinically relevant definition of abnormal behavior for public health assessment.

Main Methods:

  • Retrospective cohort study analyzing data from 10,000 Japanese children under 18 with influenza.
  • Comparison of severe abnormal behavior incidence across different NI treatment groups (oseltamivir, peramivir, zanamivir, laninamivir) and no NI.
  • Utilized a refined definition of severe abnormal behavior aligned with public health concerns.

Main Results:

  • A previous study indicated a 30-fold increased relative risk of A-type abnormal behavior with oseltamivir compared to no oseltamivir.
  • Our research found that patients receiving no NI or peramivir had a higher risk of abnormal behavior than those receiving oseltamivir, zanamivir, or laninamivir.
  • The discrepancy in findings is attributed to differing definitions of abnormal behavior in the studies.

Conclusions:

  • The risk of severe abnormal behavior in pediatric influenza patients varies depending on the specific neuraminidase inhibitor (NI) administered.
  • A standardized and clinically relevant definition of severe abnormal behavior is crucial for accurate pharmacovigilance and risk assessment.
  • Further research is warranted to elucidate the complex relationship between NI and neuropsychiatric events in children.

Keywords:
Influenzaabnormal behaviorneuraminidase inhibitorsoseltamivir

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