Stella G Muthuri, The University of Nottingham
Sudhir Venkatesan, The University of Nottingham
Puja R Myles, The University of Nottingham
Jo Leonardi-Bee, The University of Nottingham
Wei Shen Lim, Nottingham University Hospitals NHS Trust
Abdullah Al Mamun, Research Bangladesh (ICDDRB)
Ashish P Anovadiya, Government Medical College and Sir Takhtsinhji General Hospital
Wildo N Araújo, University of Brasília
Eduardo Azziz-Baumgartner, Centers for Disease Control and Prevention
Clarisa Báez, Ministerio de Salud de la Provincia de Buenos Aires
Carlos Bantar, Hospital San Martín de Paraná
Mazen M Barhoush, King Saud Medical City
Matteo Bassetti, Santa Maria Misericordia Hospital
Bojana Beovic, University Medical Centre, Ljubljana
Roland Bingisser, University Hospital Basel
Isabelle Bonmarin, Institut de Veille Sanitaire
Victor H Borja-Aburto, Instituto Mexicano del Seguro Social (IMSS)
Bin Cao, Beijing Chao-Yang Hospital,
Jordi Carratala, University of Barcelona
María R Cuezzo, Ministerio de Salud de Tucumán
Justin T Denholm, Peter Doherty Institute for Infection and Immunity
Samuel R Dominguez, University of Colorado School of Medicine
Pericles A D Duarte, Universidade Estadual do Oeste do Paraná
Gal Dubnov-Raz, The Edmond and Lily Safra Children's Hospital
Marcela Echavarria, CEMIC University Hospital
Sergio Fanella, University of Manitoba
James Fraser, Bristol Children's Hospital
Zhancheng Gao, Peking University People's Hospital
Patrick Gérardin, Hospital General Universitario Gregorio Marañón
Maddalena Giannella, Hospital General Universitario Gregorio Marañón
Sophie Gubbels, Statens Serum Institut
Jethro Herberg, Imperial College London
Anjarath L Higuera Iglesias, Instituto Nacional de Enfermedades Respiratorias
Peter H Hoeger, Cath. Children's Hospital Wilhelmstift
Matthias Hoffmann, Kantonsspital St. Gallen
Xiaoyun Hu, Peking Union Medical College Hospital
Quazi T Islam, Dhaka Medical College Hospital
Mirela F Jiménez, Preceptora da Residência Médica do Hospital Fêmina
Amr Kandeel, Ministry of Health in Egypt
Gerben Keijzers, Bond University
Hossein Khalili
Gulam Khandaker
Marian Knight
Gabriela Kusznierz
Ilija Kuzman
Arthur M C Kwan
Idriss Lahlou Amine
Eduard Langenegger
Kamran B Lankarani
Yee-Sin Leo
Rita Linko
Pei Liu
Faris Madanat
Toshie Manabe
Elga Mayo-Montero
Allison McGeer
Ziad A Memish
Gokhan Metan
Dragan Mikić
Kristin G I Mohn
Ahmadreza Moradi
Pagbajabyn Nymadawa
Bulent Ozbay
Mehpare Ozkan
Dhruv Parekh
Mical Paul
Wolfgang Poeppl
Fernando P Polack
Barbara A Rath
Alejandro H Rodríguez
Marilda M Siqueira
Joanna Skręt-Magierło
Ewa Talarek
Julian W Tang
Antoni Torres
Selda H Törün
Dat Tran
Timothy M Uyeki
Annelies van Zwol
Wendy Vaudry
Daiva Velyvyte
Tjasa Vidmar
Paul Zarogoulidis
Jonathan S Nguyen-Van-Tam

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Muthuri, S. G., Venkatesan, S., Myles, P. R., Leonardi-Bee, J., Lim, W. S., Al Mamun, A., ... PRIDE Consortium Investigators (2016). Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: An individual participant data meta-analysis. Influenza and Other Respiratory Viruses, 10(3), 192-204. doi: 10.1111/irv.12363

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© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

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The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection.


A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids.


Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)].


Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.



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