Oseltamivir-zanamivir bitherapy compared to oseltamivir monotherapy in the treatment of pandemic 2009 influenza A(H1N1) virus infections

被引：25

作者：

Escuret, Vanessa ^{[1
,2
]}

Cornu, Catherine ^{[4
,5
,6
]}

Boutitie, Florent ^{[7
,8
]}

Enouf, Vincent ^{[3
]}

Mosnier, Anne ^{[12
]}

Bouscambert-Duchamp, Maude ^{[1
,2
]}

Gaillard, Segolene ^{[4
,5
,6
]}

Duval, Xavier ^{[9
]}

Blanchon, Thierry ^{[13
]}

Leport, Catherine ^{[10
,11
]}

Gueyffier, Francois ^{[4
,5
,6
]}

Van der Werf, Sylvie ^{[3
]}

Lina, Bruno ^{[1
,2
]}

机构：

[1] Hosp Civils Lyon, Ctr Natl Reference Virus Influenzae France Sud, Lab Virol Est, F-69677 Bron, France

[2] Univ Lyon 1, Fac Med Lyon Est, EA 4610, F-69372 Lyon, France

[3] Inst Pasteur, Ctr Natl Reference Virus Influenzae France Nord, CNRS, URA 1966, F-75014 Paris, France

[4] INSERM, CIC201, F-69677 Bron, France

[5] Hosp Civils Lyon, Serv Pharmacol Clin, F-69677 Bron, France

[6] Univ Lyon 1, CNRS, UMR 5558, F-69003 Lyon, France

[7] Hosp Civils Lyon, Serv Biostat, F-69003 Lyon, France

[8] Univ Lyon 1, CNRS, UMR 5558, Lab Biometrie & Biol Evolut,Serv Biostat Sante, F-69003 Lyon, France

[9] INSERM, UMR S738, Paris, France

[10] Univ Paris 07, UFR Med, Lab Rech Pathol Infect, F-75018 Paris, France

[11] APHP, Unite Coordinat Risque Epidem & Biol, F-75019 Paris, France

[12] Reseau Grp Regionaux Observat Grippe GROG, F-75018 Paris, France

[13] Univ Paris 06, INSERM, UMR S 707, UFR Med, F-75012 Paris, France

来源：

ANTIVIRAL RESEARCH | 2012年 / 96卷 / 02期

关键词：

Oseltamivir; Zanamivir; Combination therapy; Pandemic; Influenza A(H1N1)pdm09 virus; NEURAMINIDASE INHIBITOR OSELTAMIVIR; H1N1; RESISTANCE; CHILDREN;

D O I：

10.1016/j.antiviral.2012.08.002

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Background: The emergence of oseltamivir resistance in 2007 highlighted the need for alternative strategies against influenza. To limit the putative emergence of resistant viruses this clinical trial aimed to evaluate the antiviral efficacy and tolerability of oseltamivir-zanamivir (O + Z) bitherapy compared to oseltamivir monotherapy (O). This clinical trial was designed in 2008-2009 and was conducted during the A(H1N1) influenza virus pandemic in 2009-2010. The A(H1N1)pdm09 viruses were reported to be sensitive to oseltamivir and zanamivir but resistant to amantadine. Methods: During the pandemic phase in France, adults with influenza-like illness for less than 42 h and who tested positive to influenza A were randomised into treatment groups: (0 + Z) or (0). Patients had a nasal wash at day 0, before the beginning of treatment and daily at days 1 to 4. They also had a nasal swab at days 5 and 7 to check for the negativation of viral excretion. Virological response was assessed using the GAPDH adjusted M gene quantification. Results: Analysis was possible for 24 patients, 12 in the (O + Z) arm and 12 in the (O) arm. The mean viral load decreased at around 1 log(10) cgeq/mu l per day regardless of allocated treatment group. We could not detect any significant difference between treatment groups in the duration needed to alleviate symptoms. All treatments were well tolerated. No oseltamivir-resistant H275Y NA mutated virus has been detected in patients of both treatment groups. Conclusions: The sample size of our study is too limited to be fully informative and we could not detect whether combination therapy (O + Z) improves or reduces the effectiveness of oseltamivir in the treatment of influenza A(H1N1)pdm09 virus infection in community patients. Additional studies are needed to improve the antiviral treatment of patients infected with influenza virus. (C) 2012 Elsevier BM. All rights reserved.

引用

页码：130 / 137

页数：8

共 28 条

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