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抗病毒药物用于暴露后的流感预防:系统审查和网络分析

Yunli Zhao¹, Ya Gao², Gordon Guyatt³

¹Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Municipality Clinical Research Center for Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China; Precision Medicine Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Lancet (London, England)

|August 24, 2024

概括

使用神经氨基酶抑制剂的抗病毒暴露后预防可以减少高风险个体的症状性流感. 这些药物与兰纳米维尔和巴洛克萨维尔一起,也可能降低整体流感风险,而不会增加不良事件.

科学领域:

传染性疾病
药理学
公共卫生

背景情况:

使用神经氨基酶抑制剂的抗病毒暴露后预防 (PEP) 有效预防流感.
其他抗病毒类药物对流感PEP的疗效尚不清楚.
这一审查支持世卫组织流感指南的更新.

研究的目的:

系统审查和网络分析流感PEP的抗病毒药物
与安慰剂或标准治疗相比,评估各种抗病毒药物的疗效和安全性.

主要方法:

在 2023 年 9 月 20 日之前对多个随机对照试验数据库进行系统搜索.
包括33项试验,包括19096名参与者,评估了6种抗病毒药物.
使用频率学随机效应模型和GRADE确定性评估的网络元分析.

主要成果:

扎纳米维尔,奥塞拉米维尔,拉尼纳米维尔和巴洛克萨维尔可能会降低高危人群的流感症状 (中等确定性).
这些抗病毒药物可能会降低有症状的动物流感风险 (确定性低).
欧塞塔米维尔,兰纳米维尔,巴洛克萨维尔和阿曼塔丁可能会降低整体流感风险 (中等确定性);没有观察到不良事件的显著增加.

结论:

在高危人群中,使用扎纳米维尔,奥塞拉米维尔,拉尼纳米维尔或巴洛克萨维尔的抗病毒PEP可能对季节性流感有效.
这些抗病毒药物可以对有症状的动物性流感提供保护.
抗病毒药物通常不会增加不良事件,支持在特定人群中使用它们.

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