Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/142419
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dc.contributor.authorLim, Vanessa W. X.en_US
dc.contributor.authorTudor Car, Lorainneen_US
dc.contributor.authorLeo, Yee Sinen_US
dc.contributor.authorChen, Mark I-Chengen_US
dc.contributor.authorYoung, Barnabyen_US
dc.date.accessioned2020-06-22T03:22:04Z-
dc.date.available2020-06-22T03:22:04Z-
dc.date.issued2019-
dc.identifier.citationLim, V. W. X., Tudor Car, L., Leo, Y. S., Chen, M. I.-C., & Young, B. (2019). Passive immune therapy and other immunomodulatory agents for the treatment of severe influenza : systematic review and meta‐analysis. Influenza and Other Respiratory Viruses, 14(2), 226-236. doi:10.1111/irv.12699en_US
dc.identifier.issn1750-264en_US
dc.identifier.urihttps://hdl.handle.net/10356/142419-
dc.description.abstractBackground: A range of immunomodulatory therapies have been proposed as adjuncts to conventional antivirals to suppress harmful inflammation during severe influenza infection. We conducted a systematic review to assess available data of the effect of adjunctive non‐corticosteroid immunomodulatory therapy and potential adverse effects. Method: We searched MEDLINE, Embase, Web of Science and clinical trial databases for published and unpublished studies, and screened the references of included articles. We included RCTs, quasi‐RCTs and observational studies of virologically confirmed influenza infections in hospitalised patients. We did not restrict studies by language of publication, influenza type/subtype or age of participants. Where possible, we pooled estimates of effect using random‐effects meta‐analysis models. Results: We identified 11 eligible studies for : inclusion: five studies (4 RCTs and 1 observational; 693 individuals) of passive immune therapy; four studies (3 RCTs and 1 observational; 1120 individuals) of macrolides and/or non‐steroidal anti‐inflammatory drugs (NSAIDs), one RCT of mTOR inhibitors (38 individuals), and one RCT of statin therapy (116 individuals). Meta‐analysis of RCTs of passive immune therapy indicated no significant reduction in mortality (OR 0.84, 0.37‐1.90), but better clinical outcomes at Day 7 (OR 1.42, 1.05‐1.92). There was a significant reduction in mortality associated with macrolides and/or NSAIDs (OR 0.28; 0.10‐0.77). Conclusions: Passive immune therapy is unlikely to offer substantial mortality benefit in treatment of severe seasonal influenza, but may improve clinical outcomes. The effect of other immunomodulatory agents is uncertain, but promising. There is a need for high‐quality RCTs with sufficient statistical power to address this evidence gap.en_US
dc.language.isoenen_US
dc.relation.ispartofInfluenza and Other Respiratory Virusesen_US
dc.rights© 2019 The Authors (published by John Wiley & Sons Ltd). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.en_US
dc.subjectScience::Medicineen_US
dc.titlePassive immune therapy and other immunomodulatory agents for the treatment of severe influenza : systematic review and meta-analysisen_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.identifier.doi10.1111/irv.12699-
dc.description.versionPublished versionen_US
dc.identifier.pmid31733048-
dc.identifier.scopus2-s2.0-85075331882-
dc.identifier.issue2en_US
dc.identifier.volume14en_US
dc.identifier.spage226en_US
dc.identifier.epage236en_US
dc.subject.keywordsAdjunctive Therapiesen_US
dc.subject.keywordsInfluenzaen_US
item.grantfulltextopen-
item.fulltextWith Fulltext-
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