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The Japanese Journal of Antibiotics
Vol.75 No.4 December 2022

◆原著

Comparative analysis of laninamivir octanoate hydrate in inhalation suspension set and other anti-influenza drugs in treating influenza in children
Soichiro Ando
P.63-82, 2022

 Purpose: Laninamivir octanoate hydrate is a long-acting neuraminidase inhibitor but may not be effective in infants, who generally experience inhalation difficulty. No study has compared the clinical profiles of Laninamivir Nebulizer, the inhalation suspension set form of this drug, and other anti-influenza drugs and different patient statuses. Here, we compared the effectiveness and adverse events of Laninamivir Nebulizer inhalation and treatment with those of other anti-influenza drugs.
 Patients and Methods: One hundred twenty-six children with influenza were divided into the following groups according to their therapeutic scheme: Laninamivir Nebulizer, all other drugs except for Laninamivir Nebulizer, Laninamivir, and Oseltamivir. The primary endpoints of the present study were time to resolution of fever and rates of household members with secondary infection. Adverse events were also analyzed.
 Results: According to the Log rank test results, the mean time to resolution of fever for the Laninamivir Nebulizer group did not significantly differ from that for the Other drugs, Laninamivir, and Oseltamivir groups for both influenza A and B subtypes. The hazard ratio of the time to resolution of fever for the Laninamivir Nebulizer group did not significantly differ from that for the Other drugs, Laninamivir, and Oseltamivir groups for both influenza A and B and in the influenza A cohort. However, the mean time to resolution of fever for the Laninamivir Nebulizer group was significantly shorter than that for the Other drugs (Laninamivir Nebulizer vs. Other drugs groups = 51.1 ± 4.8 and 70.8 ± 8.1 h, respectively, p = 0.0133*), Laninamivir (Laninamivir Nebulizer vs. Laninamivir groups = 51.2 ± 4.8 and 71.8 ± 10.0 h, respectively, p = 0.0454*), and Oseltamivir (Laninamivir Nebulizer vs. Oseltamivir group = 51.1 ± 4.8 and 94.5 ± 14.2 h, respectively, p = 0.0015*) groups in the influenza B cohort. The hazard ratio for time to resolution for the Laninamivir Nebulizer group was significantly greater than that for the Other drugs (Laninamivir Nebulizer group = 1.87 [95% CI: 1.05–3.35], p = 0.0347*] and Oseltamivir (Laninamivir Nebulizer group = 3.38 [95% CI: 1.27–9.00], p = 0.0151*] groups in the influenza B cohort. Both the hazard ratio of the rate of household members with secondary infection and the odds ratio did not significantly differ between the Laninamivir Nebulizer and other drug treatment groups. Although 11.8% (6/51) of the patients cried during nebulizer-mediated inhalation in the Laninamivir Nebulizer group, effectiveness, household transmission, and adverse events did not significantly differ between patients who cried and those who did not during nebulizer-mediated inhalation.
 Conclusions: Clinical profiles of the Laninamivir Nebulizer group were equivalent to those of other anti-influenza drug treatment groups. Laninamivir Nebulizer may be a good therapeutic option for infants with influenza and inhalation difficulty.