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Viruses 2018, 10(9), 454; https://doi.org/10.3390/v10090454

Neuraminidase Inhibitors in Influenza Treatment and Prevention–Is It Time to Call It a Day?

Frankfurt Institute for Advanced Studies, 60438 Frankfurt am Main, Hessen, Germany
These authors shared the first author position.
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Received: 16 July 2018 / Revised: 15 August 2018 / Accepted: 22 August 2018 / Published: 25 August 2018
(This article belongs to the Special Issue What’s New with Flu?)
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Abstract

Stockpiling neuraminidase inhibitors (NAIs) such as oseltamivir and zanamivir is part of a global effort to be prepared for an influenza pandemic. However, the contribution of NAIs for the treatment and prevention of influenza and its complications is largely debatable due to constraints in the ability to control for confounders and to explore unobserved areas of the drug effects. For this study, we used a mathematical model of influenza infection which allowed transparent analyses. The model recreated the oseltamivir effects and indicated that: (i) the efficacy was limited by design, (ii) a 99% efficacy could be achieved by using high drug doses (however, taking high doses of drug 48 h post-infection could only yield a maximum of 1.6-day reduction in the time to symptom alleviation), and (iii) contributions of oseltamivir to epidemic control could be high, but were observed only in fragile settings. In a typical influenza infection, NAIs’ efficacy is inherently not high, and even if their efficacy is improved, the effect can be negligible in practice. View Full-Text
Keywords: oseltamivir; neuraminidase inhibitor; influenza; mathematical modeling; epidemics oseltamivir; neuraminidase inhibitor; influenza; mathematical modeling; epidemics
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Parra-Rojas, C.; Nguyen, V.K.; Hernandez-Mejia, G.; Hernandez-Vargas, E.A. Neuraminidase Inhibitors in Influenza Treatment and Prevention–Is It Time to Call It a Day? Viruses 2018, 10, 454.

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