A network meta-analysis of the efficacy and safety of baloxavir marboxil versus neuraminidase inhibitors for the treatment of influenza in otherwise healthy patients

Vanessa Taieb; Тайеб Ванесса; Hidetoshi Ikeoka; Икеока Хидэтоши; Fang-Fang Ma; Ма Фан-Фан; Katarzyna Borkowska; Борковска Катажина; Samuel Aballea; Абальеа Самюэль; Keiko Tone; Тон Кейко; Nobuo Hirotsu; Хироцу Нобуо

doi:10.26442/00403660.2020.11.000870

Сетевой метаанализ эффективности и безопасности балоксавира марбоксила в сравнении с ингибиторами нейраминидазы при лечении гриппа у пациентов без факторов риска

Авторы: Тайеб В.¹, Икеока Х.², Ма Ф.¹, Борковска К.¹, Абальеа С.¹, Тон К.³, Хироцу Н.⁴
Учреждения:
1. Creativ-Ceutical
2. Shionogi & Co., Ltd.
3. Shionogi Limited
4. Клиника Хироцу
Выпуск: Том 92, № 11 (2020)
Страницы: 122-131
Раздел: Метаанализ
URL: https://journals.rcsi.science/0040-3660/article/view/56950
DOI: https://doi.org/10.26442/00403660.2020.11.000870
ID: 56950

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Аннотация

Цель. Балоксавир марбоксил (балоксавир) – первый ингибитор кэп-зависимой эндонуклеазы, который изучается на предмет его использования для лечения гриппа по схеме: однократный прием внутрь. В данном сетевом метаанализе (СМА) проведена оценка эффективности и безопасности балоксавира в сравнении с другими противовирусными препаратами при лечении гриппа у пациентов без факторов риска.

Методы. Систематический обзор литературы проведен на 14 ноября 2016 г. в базах Medline, Embase, CENTRAL и ICHUSHI с целью отбора рандомизированных контролируемых исследований противовирусных препаратов, применяемых для лечения гриппа. СМА, включавший 22 исследования, выполнен с целью сравнения эффективности и безопасности балоксавира и других противовирусных препаратов.

Результаты. Время до облегчения всех симптомов при лечении балоксавиром значительно короче в сравнении с занамивиром (разница в медиане времени 19,96 ч; 95% байесовский доверительный интервал – credibility interval, CrI [3,23; 39,07]). Время до прекращения выделения вируса у пациентов, принимавших балоксавир, значительно короче в сравнении с занамивиром и осельтамивиром (47,00 ч; 95% CrI [28,18; 73,86] и 56,03 ч [33,74; 87,86] соответственно). Среднее снижение вирусного титра от исходного уровня через 24 ч от начала лечения балоксавиром значительно более выражено в сравнении с другими препаратами. Различия по другим исходам эффективности незначительные. Значимых различий в безопасности балоксавира и других противовирусных препаратов не выявлено, за исключением риска развития нежелательных явлений, связанных с приемом препарата, который при лечении балоксавиром снижался в сравнении с осельтамивиром и ланинамивиром.

Заключение. СМА подтвердил, что балоксавир по показателям эффективности не уступает или превосходит другие противовирусные препараты, при этом имеет сопоставимый с ними профиль безопасности. Лечение балоксавиром приводило к значительному снижению вирусного титра в сравнении с занамивиром, осельтамивиром и перамивиром и снижению выделения вируса в сравнении с занамивиром и осельтамивиром.

Ключевые слова

балоксавир, грипп, сетевой метаанализ, пациенты без факторов риска

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