Neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.
BACKGROUND
Cystic fibrosis is the most common, life-threatening, recessively inherited disease of Caucasian populations. It is a multisystem disorder caused by a mutation in the gene encoding the cystic fibrosis transmembrane conductance regulator protein which is important in producing sweat, digestive juices and mucus.The impaired or absent function of this protein results in the production of viscous mucus within the lungs and an environment that is susceptible to chronic airway obstruction and pulmonary colonization by a range of pathogenic bacteria. Morbidity and mortality of cystic fibrosis is related to chronic pulmonary sepsis and its complications by these bacteria.Influenza can worsen the course of the disease in cystic fibrosis by increasing the risk of pneumonia and secondary respiratory complications. Antiviral agents form an important part of influenza management and include the neuraminidase inhibitors zanamivir and oseltamivir. These inhibitors can limit the infection and prevent the spread of the virus.


OBJECTIVE
To assess the effects of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.


METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Most recent search: 12 August 2009.


METHODS
Randomised controlled trials and quasi-randomised controlled trials comparing neuraminidase inhibitors with placebo or other antiviral drugs.


METHODS
Two review authors had planned to independently screen studies, extract data and assess risk of bias using standard Cochrane Collaboration methodologies. No studies were identified for inclusion.


RESULTS
No relevant studies were retrieved after a comprehensive search of the literature.


CONCLUSIONS
We were unable to identify any randomised controlled trials or quasi-randomised controlled trials on the efficacy of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis. The absence of high level evidence for the effectiveness of these interventions emphasises the need for well-designed, adequately powered, randomised controlled clinical trials.
Jagannath
Vanitha A
VA
Department of Paediatrics, KIMS Bahrain Medical Center, Um al Hassam Ave, Adliya, Manama, Bahrain, PO Box 175829.
Asokan
G V
GV
Fedorowicz
Zbys
Z
Singaram
Jai Shanthini
JS
Lee
Tim Wr
TW
D003550:Cystic Fibrosis / Q000150:complications*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy*; D009439:Neuraminidase / Q000037:antagonists & inhibitors*
D004791:Enzyme Inhibitors; D009439:Neuraminidase