TY - JOUR
T1 - Oseltamivir for coronavirus illness
T2 - post-hoc exploratory analysis of an open-label, pragmatic, randomised controlled trial in European primary care from 2016 to 2018
AU - Coenen, Samuel
AU - van der Velden, Alike W
AU - Cianci, Daniela
AU - Goossens, Herman
AU - Bongard, Emily
AU - Saville, Benjamin R
AU - Gobat, Nina
AU - de Paor, Muireann
AU - Ieven, Margareta
AU - Verheij, Theo J
AU - Butler, Christopher C
N1 - Funding Information:
As the ALIC4E trial was part of the Platform foR European Preparedness Against (Re-) emerging Epidemics (PREPARE: www. prepare-europe.eu), it was supported by the European Commission’s Seventh Framework Programme (FP7) (grant ref: HEALTH-F3-2013-602525). The funder of the study had no role in the study design; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The views expressed in this publication are those of the authors and not necessarily those of the funders, ‘arms’ length bodies, or other government departments.
Funding Information:
Samuel Coenen, Herman Goossens, Theo J Verheij, and Christopher C Butler are involved in RESCEU, an Innovative Medicines Initiative (IMI) of the European Union in which AstraZeneca, Pfizer, GlaxoSmithKline Biologicals, Sanofi Pasteur, Janssen Pharmaceutica, and Novavax are involved. Christopher C Butler reports receiving advisory board fees from Roche Molecular Systems and grant support from Roche Molecular Diagnostics; Christopher C Butler was supported by funding from a National Institute for Health Research (NIHR) Protection Research Unit on Health Care Associated Infections and Antimicrobial Resistance, by the NIHR MedTech and In Vitro Diagnostics Co-Operative at Oxford NHS Foundation Trust, and by an NIHR Senior Investigator Award. Theo J Verheij is co-principal investigator of an NIHR-funded randomised controlled trial, and principal investigator in several studies funded by the Netherlands Organization of Health Research and Development. Alike W van der Velden reports receiving advisory board fees from Reckitt Benckiser. All authors, excluding Muireann de Paor are involved in Value-Dx, another IMI project in which Abbott, Accelerate, Becton Dickinson, BioMérieux, Bio-Rad Laboratories, and Berry Consultants are partners.
Publisher Copyright:
© The Authors This is the full-length article (published online 23 Jun 2020) of an abridged version published in print. Cite this version as: Br J Gen Pract 2020;
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7
Y1 - 2020/7
N2 - BACKGROUND: Patients infected with the novel coronavirus (SARS-CoV-2) are being treated empirically with oseltamivir, but there is little evidence from randomised controlled trials to support the treatment of coronavirus infections with oseltamivir.AIM: To determine whether adding oseltamivir to usual care reduces time to recovery in symptomatic patients who have tested positive for coronavirus (not including SARS-CoV-2).DESIGN AND SETTING: Exploratory analysis of data from an open-label, pragmatic, randomised controlled trial during three influenza seasons, from 2016 to 2018, in primary care research networks, in 15 European countries.METHOD: Patients aged ≥1 year presenting to primary care with influenza-like illness (ILI), and who tested positive for coronavirus (not including SARS-CoV-2), were randomised to usual care or usual care plus oseltamivir. The primary outcome was time to recovery defined as a return to usual activities, with minor or absent fever, headache, and muscle ache.RESULTS: Coronaviruses (CoV-229E, CoV-OC43, CoV-KU1 and CoV-NL63) were identified in 308 (9%) out of 3266 randomised participants in the trial; 153 of these were allocated to usual care and 155 to usual care plus oseltamivir; the primary outcome was ascertained in 136 and 147 participants, respectively. The median time to recovery was shorter in patients randomised to oseltamivir: 4 days (interquartile range [IQR] 3-6) versus 5 days (IQR 3-8; hazard ratio 1.31; 95% confidence interval = 1.03 to 1.66; P = 0.026).CONCLUSION: Primary care patients with ILI testing positive for coronavirus (not including SARS-CoV-2) recovered sooner when oseltamivir was added to usual care compared with usual care alone. This may be of relevance to the primary care management of COVID-19.
AB - BACKGROUND: Patients infected with the novel coronavirus (SARS-CoV-2) are being treated empirically with oseltamivir, but there is little evidence from randomised controlled trials to support the treatment of coronavirus infections with oseltamivir.AIM: To determine whether adding oseltamivir to usual care reduces time to recovery in symptomatic patients who have tested positive for coronavirus (not including SARS-CoV-2).DESIGN AND SETTING: Exploratory analysis of data from an open-label, pragmatic, randomised controlled trial during three influenza seasons, from 2016 to 2018, in primary care research networks, in 15 European countries.METHOD: Patients aged ≥1 year presenting to primary care with influenza-like illness (ILI), and who tested positive for coronavirus (not including SARS-CoV-2), were randomised to usual care or usual care plus oseltamivir. The primary outcome was time to recovery defined as a return to usual activities, with minor or absent fever, headache, and muscle ache.RESULTS: Coronaviruses (CoV-229E, CoV-OC43, CoV-KU1 and CoV-NL63) were identified in 308 (9%) out of 3266 randomised participants in the trial; 153 of these were allocated to usual care and 155 to usual care plus oseltamivir; the primary outcome was ascertained in 136 and 147 participants, respectively. The median time to recovery was shorter in patients randomised to oseltamivir: 4 days (interquartile range [IQR] 3-6) versus 5 days (IQR 3-8; hazard ratio 1.31; 95% confidence interval = 1.03 to 1.66; P = 0.026).CONCLUSION: Primary care patients with ILI testing positive for coronavirus (not including SARS-CoV-2) recovered sooner when oseltamivir was added to usual care compared with usual care alone. This may be of relevance to the primary care management of COVID-19.
KW - COVID-19
KW - Coronavirus
KW - Europe
KW - Oseltamivir
KW - Primary care
KW - Randomised controlled trial
UR - https://www.scopus.com/pages/publications/85086908204
U2 - 10.3399/bjgp20X711941
DO - 10.3399/bjgp20X711941
M3 - Article
C2 - 32571773
SN - 0960-1643
VL - 70
SP - e444-e449
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 696
ER -