Long-acting neuraminidase inhibitor laninamivir octanoate (CS-8958) versus
oseltamivir as treatment for children with influenza virus infection.
Author(s): Sugaya N, Ohashi Y.
Affiliation(s): Keiyu Hospital, Department of Pediatrics, Nishi-ku, Yokohama, Kanagawa, Japan.
sugaya-n@za2.so-net.ne.jp
Publication date & source: 2010, Antimicrob Agents Chemother. , 54(6):2575-82
We conducted a double-blind, randomized controlled trial to compare a long-acting
neuraminidase inhibitor, laninamivir octanoate, with oseltamivir. Eligible
patients were children 9 years of age and under who had febrile influenza
symptoms of no more than 36-h duration. Patients were randomized to 1 of 3
treatment groups: a group given 40 mg laninamivir (40-mg group), a group given 20
mg laninamivir (20-mg group), and an oseltamivir group. Laninamivir octanoate was
administered as a single inhalation. Oseltamivir (2 mg/kg of body weight) was
administered orally twice daily for 5 days. The primary end point was the time to
alleviation of influenza illness. The primary analysis included 184 patients (61,
61, and 62 in the 40-mg group, 20-mg group, and oseltamivir group, respectively).
Laninamivir octanoate markedly reduced the median time to illness alleviation in
comparison with oseltamivir in patients infected with oseltamivir-resistant
influenza A (H1N1) virus, and the reductions were 60.9 h for the 40-mg group and
66.2 h for the 20-mg group. On the other hand, there were no significant
differences in the times to alleviation of illness between the laninamivir groups
and oseltamivir group for patients with influenza A (H3N2) or B virus infection.
Laninamivir octanoate was well tolerated. The most common adverse events were
gastrointestinal events. Laninamivir octanoate was an effective and
well-tolerated treatment for children with oseltamivir-resistant influenza A
(H1N1) virus infection. Further study will be needed to confirm clinical efficacy
against influenza A (H3N2) or B virus infection. Its ease of administration is
noteworthy, because a single inhalation is required during the course of illness.
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