Table 5. Treatment effect of oseltamivir and zanamivir versus placebo in healthy adults, children, elderly and at-risk populations (ITT – pooled results).
| Outcomes | NIa,b | First author/review | Number of included studies | Number of participants | Estimate (95%CI)c | Quality GRADEe | References of included studies |
| Healthy adults | |||||||
| Time to alleviation of symptoms | O | Burch [8] | 4 | 1410 | −13.29 (−25.15 to −3.43) | moderate | Li 2003 [104]/Nicholson 2000 [105]/Treanor 2000 [106]/Roche WVI5730 |
| Jefferson [10] | 5 | 3713 | −21.3 (−29.59 to −12.98) | Whitley 2001 [107]/Nicholson 2000 [105]/Treanor 2000 [106]/M76001/WV15819 | |||
| Z | Burch [8] | 6 | 2701 | −0.57 (−1.07 to −0.08) | high | GSK NAIA3002/GSK NAI 3001/Hayden 1997 [108]/Mäkelä 2000 [109]/MIST 1998 [110]/Puhakka 2003 [111] | |
| Time to return to normal activity | O | Burch [8] | 3 | 951 | −31.94 (−46.95 to −16.93) | moderate | Li 2003 [104]/Nicholson 2000 [105]/Treanor 2000 [106] |
| Z | Burch [8] | 4 | 3025 | −0.37 (−0.84 to 0.09) | high | Hayden 1997 [108]/Mäkelä 2000 [109]/MIST 1998 [110]/Puhakka 2003 [111] | |
| Children | |||||||
| Time to alleviation of symptoms | O | Burch [8] | 2 | 1029 | −21.05 (–33.81 to −8.29) | moderate | Johnston 2005 [112]/Whitley 2001 [107] |
| Z | Burch [8] | 2 | 737 | −0.94 (−1.43 to −0.46) | moderate | Hedrick 2000 [29]/GSK NAI30028 | |
| Wang [17] | 2 | 471/266 | −0.5 (p = 0.001)/−0.5 (p = 0.04)d | Hedrick 2000 [29]/GSK NAI30028 | |||
| Time to return to normal activity | O | Burch [8] | 1 | 695 | −30.08 (−43.35 to −16.81) | moderate | Whitley 2001 [107] |
| Z | Burch [8] | 1 | 471 | −0.5 (−1.25 to 0.25) | moderate | Hedrick 2000 [29] | |
| Elderly | |||||||
| Time to alleviation of symptoms | O | Burch [8] | 1 | 736 | −10.00 (−45.05 to 25.05) | low | Martin 2001 [113] |
| Z | Burch [8] | 5 | 475 | −1.13 (−2.90 to 0.63) | low | Boivin 2000 [114]/GSK NAI30012/Mäkelä 2000 [109]/MIST 1998 [110]/Murphy 2000 [115] | |
| Time to return to normal activity | O | Burch [8] | 3 | 734 | −98.07 (−170.98 to −25.16) | low | Roche WVI15819/Roche WVI15876/Roche WVI15878 |
| At-risk individuals | |||||||
| Time to alleviation of symptoms | O | Burch [8] | 2 | 1472 | −17.84 (−36.20 to 0.52) | moderate | Martin 2001 [113]/Johnston 2005 [112] |
| Z | Burch [8] | 7 | 1252 | −0.98 (−1.84 to −0.11) | moderate | Mäkelä 2000 [109]/Monto 1999 [30]/Murphy 2000 [115]/Boivin 2000 [114]/MIST 1998 [110]/Hedrick 2000 [29]/GSKNAI30012 | |
| Time to return to normal activity | O | Burch [8] | 5 | 1134 | −58.84 (−116.58 to −1.11) | low | Roche WVI15812/Roche WVI15872/Roche WVI15819/Roche WVI15876/Roche WVI15878 |
| Z | Burch [8] | 6 | 613 | −0.96 (−2.32 to 0.41) | low | Murphy 2000 [115]/GSK NAIB2007/Mäkelä 2000 [109]/MIST 1998 [110]/Hedrick 2000 [29]/Boivin 2000 [114] | |
a
O = 150 mg oseltamivir daily during 5 days in adults, elderly; dosage adjusted to weight in children.
b
Z = 2×10 mg inhaled zanamivir daily during 5 days in adults, elderly; dosage adjusted to weight in children.
c
difference in median hours in oseltamivir trials and difference in median days in zanamivir trials.
d
no pooling of results.
e
GRADE quality of evidence: high; moderate; low.
ITT = intention-to-treat; NI = neuraminidase inhibitor; CI = confidence interval.