Benefits of antiviral treatment for confirmed influenza

Recent research published in The Lancet has shone a light on the potential benefits of adding antiviral treatment to usual primary care for patients with influenza-like illness, seeking to determine if this approach reduces time to recovery overall, and for people in key subgroups. The study, which enrolled 3266 participants in 15 European countries during three seasonal influenza seasons, used a design that was an open-label, pragmatic, randomised controlled trial of adding oseltamivir to usual care in patients aged 1 year and older presenting with influenza-like illness in primary care. The primary endpoint was time to recovery (defined as return to usual activities, with fever, headache, and muscle ache minor or absent). Subjects had PCR-confirmed influenza infection. Time to recovery was shorter in participants randomly assigned to Recovery was observed to be faster for those receiving the antiviral drug overall (hazard ratio 1·29, 95% Bayesian credible interval [BCrI] 1·20–1·39) and in 30/36 pre-specified subgroups. The estimated absolute overall mean benefit from oseltamivir was recovery 1·02 days quicker recovery (95% [BCrI] 0·74–1·31) overall, but the benefit for patients aged 65 years or older who had more severe illness, comorbidities, and longer previous illness duration the benefit was greater: 3·20 days quicker recovery (95% BCrI 1·00–5·50). Increased vomiting/nausea was observed in the oseltamivir group. View more details about the study here.