Efficacy and safety of Anaferon for children and Anaferon for the prevention and treatment of influenza and other acute respiratory viral infections: systematic review and meta-analysis

Abstract

Aim: to evaluate the efficacy and safety of Anaferon and Anaferon for children for the prevention and treatment of of acute respiratory viral infections (ARVI)/influenza using meta-analysis. Patients and Methods: the meta-analysis included data from 11 randomized clinical trials (RCTs) involving 3079 patients aged 1 month to 69 years, of which: 1729 people were included in the meta-analysis of the preventive drugs efficacy, 1550 patients — in the meta-analysis of the therapeutic efficacy of Anaferon for children. The evaluation of the therapeutic efficacy was conducted according to the criteria "disease duration" and/or "fever duration", the evaluation of the preventive efficacy was conducted according to the criterion "the proportion of patients not falling ill with ARVI/influenza". The safety was evaluated taking into account the number of adverse events (AEs). Statistical methods included the exact Fisher criterion, the Student criterion, fixed and random effects models, the Z-test, the Cochrane-Mantel-Hensel criterion, Cochrane Q-statistics and the I2 coefficient, the Breslow-Day test, the calculation of relative risk (RR), odds ratios (OR) and their 95% confidence intervals (CI). Results: according to the criterion "the proportion of patients not falling ill with ARVI/influenza", the RR of Anaferon for children was 1.2 [95% CI 1.2; 1.3] with an OR of 2.2 [95% CI 1.7; 2.9], while for Anaferon, the RR was 6.7 [95% CI 3.8; 11.8] with an OR of 20.1 [95% CI 9.2; 44.0]. At the same time, the proportion of patients without ARVI/influenza during Anaferon intake exceeded that in the absence of preventive intervention by almost 8 times, and during Anaferon for children intake — 1.3 times vs. placebo. When evaluating the therapeutic effect of Anaferon for children, it was found that the average disease duration was 1.4 times shorter than during placebo intake, and was 4.71±2.53 days (p<0,001). The average fever duration was 2.19±1.21 days vs. 3.22±1.81 days during placebo intake (p<0,001). According to the criterion "disease duration", the weighted average effect value was 1.05 [95% CI 0.44; 1.67], according to the criterion "fever duration" — 0.97 [95% CI 0.61; 1.33] (p<0.001, p-value of the two-tailed Z-test; random effects model). The therapeutic efficacy of Anaferon for children did not depend on the etiology of ARVI, the symptoms, and the presence of comorbidity (asthma). The total number of AEs is similar to those in the comparison group. Conclusion: the conducted review and meta-analysis concerning the efficacy and safety of Anaferon and Anaferon for children for the treatment and prevention of ARVI/influenza allow us to conclude the following: 1) Anaferon for children is effective and safe for the treatment of influenza and other acute respiratory infections, regardless of the pathogen and the presence of comorbidity (asthma); 2) Anaferon and Anaferon for children are effective and safe for the prevention of acute respiratory infections/influenza, including patients with concomitant bronchopulmonary pathology and frequently ill children. KEYWORDS: ARVI, influenza, prevention, treatment, meta-analysis, Anaferon, Anaferon for children. FOR CITATION: Geppe N.A., Zaplatnikov A.L., Kondyurina E.G. et al. Efficacy and safety of Anaferon for children and Anaferon for the prevention and treatment of influenza and other acute respiratory viral infections: systematic review and meta-analysis. Russian Medical Inquiry. 2021;5(5):335–347 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-335-347.

The Supramolecular Matrix Concept

“…To study the mechanisms of ME, as a main model we chose the effect of PDs of antibodies to interferon-gamma (IFN-γ) on its antigen, IFN-γ. PDs of antibodies to IFN-γ are by far the most studied GrP [40,[61][62][63][64][65][66][67]. Using this preparation, we discovered that ME is based on conformational changes in the target molecule, in this case, its antigen, IFN-γ [68], and influences the antigen's hydration shell [69].…”

The Common Cold and Influenza in Children: To Treat or Not to Treat?

“…Drugs based on APTP Abs to IFNγ, including Anaferon for children and Ergoferon, are active against a wide spectrum of ARVI causative agents [59,79,80]. A systematic review with a meta-analysis of nine double-blind placebo-controlled RCTs that included data from 2790 patients older than 1 month showed that Anaferon for children, compared to placebo, significantly reduced the duration of the disease as well as the duration of individual symptoms in ARVI [79].…”

“…Drugs based on APTP Abs to IFNγ, including Anaferon for children and Ergoferon, are active against a wide spectrum of ARVI causative agents [59,79,80]. A systematic review with a meta-analysis of nine double-blind placebo-controlled RCTs that included data from 2790 patients older than 1 month showed that Anaferon for children, compared to placebo, significantly reduced the duration of the disease as well as the duration of individual symptoms in ARVI [79]. The weighted average effect size was 1.05 for the endpoint "duration of the disease" [95% CI 0.44; 1.67], and 0.97 for the endpoint "duration of fever" [95% CI 0.61; 1.33] (p < 0.001, p-value of the two-sided Z-test; model of random effects).…”

“…The efficacy of Anaferon for children with ARVI did not depend on the causative agent and the presence of comorbidities. According to this meta-analysis, the preventive efficacy of Anaferon for children against ARVI pathogens, including patients with bronchopulmonary pathology and children who were often ill, was 1.3 times higher than that of a placebo (the criterion "the proportion of patients who did not get sick": relative risk (RR) = 1.25 [95% CI 1.2; 1.3]; OR = 2.22 [95% CI 1.7; 2.9]) [79]. Data from a meta-analysis published in late 2021 demonstrated that Ergoferon is 1.5 times more effective in reducing the duration of fever compared to a placebo (OR = 1.499, p = 0.0002).…”