Antiviral drugs for the treatment of influenza: a systematic review and economic evaluation

Abstract

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Reducing uncertainty in managing respiratory tract infections in primary care

“…Two recent systematic reviews, based on evidence from prophylaxis (four trials), treatment (12 trials), and post-exposure prophylaxis (four trials), both concluded that these drugs did not result in meaningful symptomatic improvement in seasonal influenza. 119,120 Whether oseltamivir reduces influenza-related LRTI complications remains unclear. The 2005 Cochrane systematic review concluded that it did.…”

Use of Implicit and Explicit Bayesian Methods in Health Technology Assessment

“…This is partly due to the publication of the method guides by NICE (22,23) which promotes the use of relevant methods but also due to the development of freely available, more user-friendly, Bayesian specialist software packages such as WinBUGS (10) (24) presented separate meta-analyses for the 2 active treatments (zanamivir and oseltamivir) under review compared to placebo as no head-to-head trials of the 2 active treatments existed. However, the updated review, published in 2009 (25), applied explicit Bayesian methods to obtain an indirect estimate of the 2 treatments compared to one another as well as placebo. Similarly, the recently published review of obesity treatments(26) collated and updated the previous 2 HTAs (evaluating the effectiveness and cost-effectiveness of Orlistat (27) and Sibutramine (28) separately) using explicit Bayesian mixed treatment comparison methods to bring the evidence together within a single analysis.…”

Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds

“…Recent systematic reviews and meta-analyses of the therapeutic use of NIs, 70,216,217 show that a clinically beneficial effect of oseltamivir and zanamivir (Relenza ® , GSK) depends on treatment starting within 48 hours of first symptoms when seasonal (inter-pandemic) influenza is circulating. In our study, only the Quidel QuickVUE Influenza A&B test provided results soon enough to influence treatment decisions that might benefit patients -and then only to a small percentage (150/1240, 12.1%) of admissions.…”