The association between oseltamivir use and adverse neuropsychiatric outcomes among TRICARE beneficiaries, ages 1 through 21 years diagnosed with influenza

Casscells, S. Ward; Granger, Elder; Kress, Amii M.; Linton, Andrea

doi:10.1515/ijamh.2009.21.1.79

Cited by 33 publications

(27 citation statements)

References 8 publications

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“…Although thought initially to be oseltamivir related, the acute psychiatric reactions are probably influenza related, 36 with limited data suggesting a protective effect in oseltamivir-treated influenza patients. 38 …”

Section: Discussionmentioning

confidence: 99%

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Anekthananon

Pukrittayakamee

Ratanasuwan

et al. 2012

Journal of Antimicrobial Chemotherapy

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ObjectivesLong-term chemoprophylaxis using neuraminidase inhibitors may be needed during influenza epidemics but safety data are limited to several weeks. We sought to assess the tolerability of oseltamivir and zanamivir as primary prophylaxis over 16 weeks.MethodsWe conducted a parallel group, double blind, 2 (active drug) :1 (placebo) randomized trial of oral oseltamivir/placebo or inhaled zanamivir/placebo over 16 weeks in healthy, Thai hospital professionals at two Bangkok hospitals. The primary endpoint was study withdrawal due to drug-related (possibly, probably, definitely) serious or adverse events (AEs) graded ≥2.ResultsRecruited subjects numbered 129 oseltamivir/65 placebo and 131 zanamivir/65 placebo. A total of 102 grade ≥2 AEs were reported or detected in 69 subjects: 23/129 (17.8%) versus 15/65 (23.1%) (P = 0.26), and 23/131 (17.6%) versus 8/65 (12.3%) (P = 0.28). Intercurrent infections/fevers [26/102 (25.5%)], abnormal biochemistry [25/102 (24.5%)] and gastrointestinal symptoms [18/102 (17.6%)] were the most frequently reported AEs. There were no drug-related study withdrawals. Eight serious AEs were all due to intercurrent illnesses. Laboratory, lung function and ECG parameters were similar between drugs and placebos.ConclusionsOseltamivir and zanamivir were well tolerated in healthy hospital professionals. Both drugs can be recommended for primary influenza prophylaxis for up to 16 weeks.

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Section: Discussionmentioning

confidence: 99%

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Anekthananon

Pukrittayakamee

Ratanasuwan

et al. 2012

Journal of Antimicrobial Chemotherapy

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“…85 Further US healthcare database analyses have been published since the Roche review and confirm these observations in both the general population aged ≥ 1 year 86 and those aged 1–17 years 86 and 1–21 years. 87 A literature review revealed that NPAEs have been reported in Japanese and Taiwanese children with influenza before initiation of oseltamivir treatment; events occurring before treatment were similar to those occurring afterwards. 85 A similar observation was also made in a more recent Taiwanese clinical case series.…”

Section: Safetymentioning

confidence: 99%

Oseltamivir in seasonal influenza: cumulative experience in low- and high-risk patients

Dutkowski

2010

Journal of Antimicrobial Chemotherapy

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Seasonal influenza viruses cause annual disease epidemics that affect individuals at low and high risk for secondary illnesses. Influenza vaccines are widely used in high-risk patients to prevent infection, but the protection afforded varies by population; uptake is also limited in some groups. Antiviral drugs for influenza are now readily available. Oseltamivir is the most widely used antiviral for the treatment and prophylaxis of seasonal influenza, and its efficacy and safety are now well established in a variety of populations. In addition to decreasing the severity and duration of the symptoms of influenza, clinical and epidemiological studies demonstrate that oseltamivir significantly reduces the frequency of secondary illnesses and exacerbation of underlying conditions; survival is also significantly improved in seriously ill patients who are hospitalized with severe influenza. Resistant viruses are isolated with a low frequency during oseltamivir treatment (0.33% in adults and 4.0% in children among almost 2000 oseltamivir-treated patients enrolled onto Roche-sponsored clinical trials of oseltamivir treatment during the oseltamivir development programme). However, an oseltamivir-resistant influenza A (H1N1) virus emerged in Europe during the 2007–08 season and circulated in the southern and northern hemispheres in 2008–09. No link with oseltamivir usage could be detected, and the clinical impact of these viruses was limited. Oseltamivir-susceptible pandemic (H1N1) 2009 viruses now predominate in many countries. Oseltamivir is generally well tolerated, with a similar adverse event profile to placebo.

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“…The 2009 H1N1 viruses analysed, to date, are all resistant to the adamantadine class of antivirals but remain sensitive to neuraminidase inhibitors [3]. Available data indicate that the rate of prescribing antivirals to seasonal influenza virus-infected individuals, ranging in age from infants to adults, is similar between males and females in the USA [113-115]. In contrast, inappropriate prescription of antibiotics for seasonal influenza is greater for women [114].…”

Section: H1n1 Overviewmentioning

confidence: 99%

The impact of sex, gender and pregnancy on 2009 H1N1 disease

et al. 2010

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Children and young adults of reproductive age have emerged as groups that are highly vulnerable to the current 2009 H1N1 pandemic. The sex of an individual is a fundamental factor that can influence exposure, susceptibility and immune responses to influenza. Worldwide, the incidence, disease burden, morbidity and mortality rates following exposure to the 2009 H1N1 influenza virus differ between males and females and are often age-dependent. Pregnancy and differences in the presentation of various risk factors contribute to the worse outcome of infection in women. Vaccination and antiviral treatment efficacy also vary in a sex-dependent manner. Finally, sex-specific genetic and hormonal differences may contribute to the severity of influenza and the clearance of viral infection. The contribution of sex and gender to influenza can only be determined by a greater consideration of these factors in clinical and epidemiological studies and increased research into the biological basis underlying these differences.

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The association between oseltamivir use and adverse neuropsychiatric outcomes among TRICARE beneficiaries, ages 1 through 21 years diagnosed with influenza

Abstract: Our retrospective study found no evidence that oseltamivir treatment for influenza increased the risk of adverse neuropsychiatric outcomes among the study population. An additional study focusing on prospective medical surveillance of influenza patients is warranted.

Cited by 33 publications

References 8 publications

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Oseltamivir and inhaled zanamivir as influenza prophylaxis in Thai health workers: a randomized, double-blind, placebo-controlled safety trial over 16 weeks

Oseltamivir in seasonal influenza: cumulative experience in low- and high-risk patients

The impact of sex, gender and pregnancy on 2009 H1N1 disease

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