title: Zanamivir: a significant reduction in viral load during treatment in military conscripts with influenza.
abstract: A randomized, double-blind, placebo-controlled, parallel-group trial performed at 5 residential units of the Finnish Defence Forces was conducted to assess the antiviral activity, efficacy and safety of inhaled zanamivir for the treatment of naturally acquired influenza. Conscripts were recruited within 2 d of onset of typical influenza symptoms and received inhaled zanamivir 10 mg via a Diskhaler twice daily for 5 d or matching placebo. Time to alleviation of clinically significant symptoms of influenza was the primary endpoint. Viral load measurements were made using quantitative real-time polymerase chain reaction assays. 435/588 patients (74%) had laboratory-confirmed influenza infection. The mean area under the curve for viral load during the first 48 h of treatment was 8.48 [95% confidence interval (95% CI) 2.85 to 14.11] log10 vRNA copies/ml x h lower in the zanamivir group compared with placebo (p = 0.003). Zanamivir reduced the time to alleviation of symptoms versus placebo in the influenza-positive group (medians 2.0 vs 2.33 d; 95% CI-0.17 to 1.0 d, p = 0.08). Zanamivir rapidly reduced viral load following the start of therapy compared with placebo and was well tolerated.
authors.affiliation: Department of Otorhinolaryngology, Turku University Hospital, Turku, Finland. tuomo.puhakka@utu.fi
authors.forename: Tuomo
authors.initials: T
authors.lastname: Puhakka
authors.forename: Heikki
authors.initials: H
authors.lastname: Lehti
authors.forename: Raija
authors.initials: R
authors.lastname: Vainionpää
authors.forename: Vesa
authors.initials: V
authors.lastname: Jormanainen
authors.forename: Markku
authors.initials: M
authors.lastname: Pulkkinen
authors.forename: Stephen
authors.initials: S
authors.lastname: Sharp
authors.forename: Caron
authors.initials: C
authors.lastname: Kerr
authors.forename: Maria
authors.initials: M
authors.lastname: Dempsey
authors.forename: Christopher Ja
authors.initials: CJ
authors.lastname: Ring
authors.forename: Chantelle
authors.initials: C
authors.lastname: Ward
authors.forename: Margaret
authors.initials: M
authors.lastname: Tisdale
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001483:Base Sequence; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006146:Guanidines; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008889:Military Personnel; D008969:Molecular Sequence Data; D009975:Orthomyxoviridae / Q000187:drug effects* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods; D011336:Probability; D011714:Pyrans; D012367:RNA, Viral / Q000032:analysis; D012016:Reference Values; D012720:Severity of Illness Index; D012794:Sialic Acids / Q000008:administration & dosage*; D016896:Treatment Outcome; D019562:Viral Load; D053243:Zanamivir
chemical_list: D006146:Guanidines; D011714:Pyrans; D012367:RNA, Viral; D012794:Sialic Acids; D053243:Zanamivir