Antivirals for post-exposure prophylaxis of influenza: a systematic review and network meta-analysis

作者：Yunli Zhao, Ya Gao, Gordon Guyatt, Timothy M. Uyeki, Ping Liu, Ming Liu, Yanjiao Shen, Xiaoyan Chen, Shuyue Luo, Xingsheng Li, Rongzhong Huang, Qiukui Hao · 发表于：The Lancet · 年份：2024 · DOI：10.1016/s0140-6736(24)01357-6 · 被引用次数：41 · 研究领域：Influenza Virus Research Studies、Respiratory viral infections research、Infection Control and Ventilation

BACKGROUND: Antiviral post-exposure prophylaxis with neuraminidase inhibitors can reduce the incidence of influenza and the risk of symptomatic influenza, but the efficacy of the other classes of antiviral remains unclear. To support an update of WHO influenza guidelines, this systematic review and network meta-analysis evaluated antiviral drugs for post-exposure prophylaxis of influenza. METHODS: We systematically searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Global Health, Epistemonikos, and ClinicalTrials.gov for randomised controlled trials published up to Sept 20, 2023 that evaluated the efficacy and safety of antivirals compared with another antiviral or placebo or standard care for prevention of influenza. Pairs of reviewers independently screened studies, extracted data, and assessed the risk of bias. We performed network meta-analyses with frequentist random effects model and assessed the certainty of evidence using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. The outcomes of interest were symptomatic or asymptomatic infection, admission to hospital, all-cause mortality, adverse events related to antivirals, and serious adverse events. This study is registered with PROSPERO, CRD42023466450. FINDINGS: Of 11 845 records identified by our search, 33 trials of six antivirals (zanamivir, oseltamivir, laninamivir, baloxavir, amantadine, and riman...