Evidence based evaluation of anti - virus medicines for virosis communicable respiratory disease_Chinese Journal of Evidence-Based Medicine

Authors：

CAI Yujia ¹ , SUN Xin ² , LI Youping ¹² , XU Juan ³ , TANG Guangmin ³ , MA Tao ³ , LI Xia ³ , LU Jun ³

1. Chinese Cochrane Center; West China Hospital; Sichuan University; Chengdu; 610041; China2. Key Lab of Transplant Engineering and Immunology （Ministry of Health; China）; Sichuan University3. West China Medicine school; Sichuan University;

Corresponding author：

Keywords：

Virosis communicable respiratory disease; anti-virus

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Objectives 　Re-evaluation the clinical evidence of. anti-virus medicines for virosis communicable respiratory disease on the effectiveness, safety and health economy.
Methods 　To search CL (2003 Issue 1), Medline (1966-2003.5), CCOHTA, SBU, NICE and NCCHTA and collect all CSRs and HTA with computer . The quality of evaluation partly based on QUOROM will be done before results analysed. If heterogeneity does not exist in CSRs and HTA, a Meta-analysis will be re-conducted.
Results 　4 CSRs (38 RC, n=22 835) and 5 HTA (28 RCT, n=139 281) were included. Due to the significant heterogeneity between these studies, further Meta-analysis could not be conducted, and descri ptive conclusions were conducted only.
Conclusions 　Neuraminidase inhibitors (zanamivir and oseltamivir) are more effective than placebo in reducing the duration of symptoms of patients with basic disease, and have limited effectiveness in health adults. But, both are well tolerated and reduce the rate of contracting influenza in all individuals. For prevention, neuraminidase inhibitors cost more and are not suitable as first-line drug. 2. Diamantane is more effective than placebo in reducing the duration of having fever, and effectively prevents the influenza A. Amantadine and rimantadine have comparable effectiveness in the prevention, although rimantadine induces fewer adverse effects than amantadine. 3. The number of the childrenpatients of upper respiratory tract infection prevented and treated by ribavirin is too small to draw any conculsion now.

Citation： CAI Yujia,SUN Xin,LI Youping,XU Juan,TANG Guangmin,MA Tao,LI Xia,LU Jun. Evidence based evaluation of anti - virus medicines for virosis communicable respiratory disease. Chinese Journal of Evidence-Based Medicine, 2003, 03(2): 121-127. doi: Copy

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1. ［1］Kimberlin DW, Coen DW, et al. Molecular mechanism of antiviralresistance Antiviral R es, 1995; 26(4): 369-401. 10. PintoLH , Holsingcr LJ. et al. Influenza virus M2 protein has ion channel activity [J ]. Cell 1992,69(3) :517-528.
2. ［2］Hay AJ. The action of adamantanamines against influenza A virus es: inhibition of the M2 ion channel protein [J]. Semin Virol 1992; 3: 21- 30.
3. ［3］Hay AJ, Zambon MC, et al. Molecular basis of resistance of influenza A viruses to amantadine [J]. J Antimicrob Chemother 1986; 18(suppl B): 19 - 29.
4. ［4］Fleming DM. Managing influenza: amantadine rimantadine and beyond [ J]. Int 1 Clin Pract 2001 ;55(3): 189 - 195.
5. ［5］Waghorn SL, Goa kl. Zanarmivir [J]. Drugs 1998;55(5):721 -725.
6. ［6］利巴书林滴鼻治疗感冒优于静脉滴注[J].中国新药与临床杂志2000;19(2).
7. ［7］国家药物目录.2000.国家食品与药品监督管理局.
8. ［8］Jefferson TO, Demicheli V, Deeks J J, Rivetti D Amantadine and rimantadine for preventing and treating influenza A in adults CSR. CL 2003 - 1.
9. ［9］Jefferson TO, Tyrrell D Antivirals for the Common Cold CSR CL 2003-1.
10. ［10］Jcfferson T, Demicheli V, Deeks J, Rivetti D Neuraminidase in hihitors for preventing and treating influenza in healthy adults CSR Cl 2003-1.
11. ［11］Randolph AG, Wang EEL Ribavirin for respiratory syncylalvirus infection of the lower respiratory tract CSR CL 2003-1.
12. ［12］Donald R. Husereau, B. Sc. Pharm M. Sc. 1Bruce Brady , M. A. , M. Sc. 1 Allison McGeer MD, FRCPC2 Oseltamivir for thetreament of suspected influenza-a clinical and economic assess ment. Issue 21 2001 CCOHTA.
13. ［13］Burls A, Clark W, Stewart T, Preston C, Bryan S, JefferonT, et al. Zanamivir for the treatment of influenza in adults: a systematic review and economic evaluation. HTA 2002; 6 ( 9 ). N HSR&D HTA Programme.
14. ［14］Full Guidance on the the use of zanamivir, oseltaamivir and amantadine for the treatment of influenza Technology Appraisal Guidance No. 58 NHS February 2003.
15. ［15］Do neuraminidase inhibitors prevent influenza Issue 27 November2001 CCOHTA.
16. ［16］Treating influenza by medication - Zanamivir SBU Alert May22, 2001.
17. ［17］Gideon Koren, Susan King, Sandra Knowles, Elizabeth Phillips Ribavirin in the treatment of SARS: A new trick for anold drug [J]? JAMC 13 MAI 2003; 168 (10).
18. ［18］SARS: experience at Prince of Wales Hospital, Hong Kong [J].THE LANCET Vol 361 May 3, 2003.

Chinese Journal of Evidence-Based Medicine

Evidence based evaluation of anti - virus medicines for virosis communicable respiratory disease

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