Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenzavirus infections

摘要: Background The sialic acid analogue zanamivir (GG167) is a selective inhibitor of influenza A and B virus neuraminidases. These viral enzymes are essential for the release from infected cells, they may also reduce inactivation by respiratory secretions. When administered experimentally directly to tract, has potent antiviral effects. We assessed therapeutic activity in adults with acute influenza. Methods conducted separate randomized, double-blind studies 38 centers North America 32 Europe during season 1994-1995. total 417 influenza-like illness <48 hours' duration were randomly assigned one three treatments: 6.4 mg intranasal spray plus 10 inhalation, inhalation placebo spray, or both routes. Treatments self-administered twice daily five days. Results Of 262 patients confirmed influenzavirus infection (63 percent all patients), median length time alleviation major symptoms was day shorter (four days vs. days) 88 given inhaled (P=0.02) 85 alone (P=0.05) than 89 placebo. Among who febrile at enrollment among those began treatment within 30 hours after onset symptoms, four groups seven group (P<0.01). Viral titers nasal washings significantly lower group. topically well tolerated. Conclusions In infections, direct administration neuraminidase inhibitor, zanamivir, tract safe reduces if begun early. (N Engl J Med 1997;337:874-80.)