Abstract
Influenza viruses exacerbate chronic obstructive pulmonary disease (COPD) with considerable morbidity and mortality. Zanamivir and oseltamivir are effective in treating influenza. However, their efficacy in relieving influenza symptoms in COPD patients remains unknown, with the lack of controlled trials in this subject. Therefore, we conducted this randomized controlled trial to investigate the clinical efficacy of both interventions in this population. Patients were allocated to two groups (80 patients each): oseltamivir (OSELTA) and zanamivir (ZANA) groups. Oseltamivir (75 mg) was orally administered twice daily for 5 days, while zanamivir (10 mg) was inhaled twice daily for 5 days. Clinical parameters including body temperature, influenza symptoms (i.e., sore throat, cough, etc.), and serial blood tests were recorded on days 1, 3, and 7. We analyzed primary (changes in body temperature) and secondary outcomes (changes in non-specific symptoms) using the pre-protocol and intention-to-treat analyses. Differences between groups were assessed using t-test. Oseltamivir and zanamivir significantly reduced body temperature on the 3rd day after treatment; however, the number of patients who reported clinical improvement in influenza-like symptoms was significantly higher in the OSELTA group compared to the ZANA group on days 3 (85 vs 68.8%, P=0.015) and 7 (97.5 vs 83.8%, P=0.003). However, no significant changes in hematological (white blood cells and its subtypes) and inflammatory (C-reactive protein) parameters were noted (P>0.05). Our results suggested that oseltamivir and zanamivir are effective in reducing body temperature, while oseltamivir led to better clinical improvement regarding influenza-like symptoms in patients with COPD.
Highlights
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by chronic bronchitis and airflow obstruction
COPD was diagnosed based on the guidelines proposed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2020 [14), which is based on the severity of airflow limitation, symptoms assessment (using the COPD assessment test (CAT) or the modified Medical Research Council questionnaire), and the history of acute exacerbations
D° is the mean difference between the OSELTA group and the ZANA group
Summary
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by chronic bronchitis and airflow obstruction. It is an irreversible disease with progressive deterioration of respiratory symptoms [1,2]. Persistent airway inflammation is a cardinal feature of COPD [3], which is aggravated by the influence of lifestyle factors, especially smoking [4]. Inflammatory cells such as macrophages and neutrophils aggregate in large numbers in the airway mucosa. People with chronic inflammatory diseases of the respiratory system, such as COPD, have a high risk for influenza complications, because influenza may aggravate the underlying condition or make these individuals susceptible to secondary bacterial infections and pneumonia
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Schedule a callMore From: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
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