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There is a need for robust research to clarify antivirals' role in severe influenza, as their benefits, though potential, remain uncertain for survival and critical outcomes, underscoring the importance of individualized care.
A comprehensive systematic review and network meta-analysis published in the Lancet shed light on the potential benefits and limitations of antivirals for hospitalized patients with severe influenza. Conducted to support updated World Health Organization (WHO) influenza clinical guidelines, Ya Gao et al. evaluated 8 randomized controlled trials with 1,424 participants (mean age 36 to 60 years; 43 to 78% males). The findings revealed both possibilities and challenges associated with using antivirals for treating severe influenza.
The analysis included trials published up to September 2023, focusing on patients with suspected or confirmed influenza. Researchers systematically reviewed databases like Embase, ClinicalTrials.gov and MEDLINE assessing antivirals against standard care, placebo, or other antivirals. The study prioritized outcomes critical to clinical decisions, such as mortality, symptom relief, intensive care unit (ICU) admission, and adverse events.
Major Findings
Despite these findings, uncertainty persists. The limited number of high-quality trials and small sample sizes deter definitive conclusions about the ideal antiviral therapy for severe influenza. Publication bias couldn't be assessed due to the limited number of studies.
The review underscored the pressing need for more high-quality, large-scale trials to direct clinical practice and improve outcomes for patients with severe influenza. Until then, clinicians must rely on the best available evidence and WHO recommendations for managing this potentially life-threatening condition.
Lancet
Antivirals for treatment of severe influenza: a systematic review and network meta-analysis of randomised controlled trials
Ya Gao et al.
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