The risk of hospitalization for ambulatory patients with influenza was not affected by treatment with oseltamivir, according to a systematic review and meta-analysis, but gastrointestinal adverse events were increased. “To justify continued use for this purpose, an adequately powered trial in a suitably high-risk population is justified,” the authors conclude.
Based on hospitalization as pooled risk ratio (RR) and risk difference (RD) estimates, the review article shows: “Of 2,352 studies identified, 15 were included. The intention-to-treat infected (ITTi) population was comprised of 6,295 individuals with 54.7% prescribed oseltamivir. Across study populations, 53.6% (5,610 of 10,471) were female and the mean age was 45.3 (14.5) years. Overall, oseltamivir was not associated with reduced risk of hospitalization within the ITTi population (RR, 0.77; 95% CI, 0.47-1.27; RD, −0.14%; 95% CI, −0.32% to 0.16%). Oseltamivir was also not associated with reduced hospitalization in older populations (mean age ≥65 years: RR, 0.99; 95% CI, 0.19-5.13) or in patients considered at greater risk of hospitalization (RR, 0.90; 95% CI, 0.37-2.17). Within the safety population, oseltamivir was associated with increased nausea (RR, 1.43; 95% CI, 1.13-1.82) and vomiting (RR, 1.83; 95% CI, 1.28-2.63) but not serious adverse events (RR, 0.71; 95% CI, 0.46-1.08).”