Oseltamivir and the risk of influenza-related complications and hospitalizations in patients with diabetes
Oseltamivir and the risk of influenza-related complications and hospitalizations in patients with diabetes
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DOI：
10.1016/j.clinthera.2007.10.001
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发表时间：
2007-10-01
影响因子：
3.2
通讯作者：
Blumentals, William A.
中科院分区：
文献类型：
--
作者：
Orzeck, Eric A.;Shi, Nianwen;Blumentals, William A.
目的：本回顾性队列研究的亚组分析从管理式护理的角度研究了接受奥司他韦治疗流感和未接受抗病毒治疗的糖尿病患者流感相关并发症和住院的风险。方法：汤姆森医疗市场扫描研究数据库6个流感季节的健康保险索赔数据（10月1日至3月31日），2000年和2006年之间被用来确定患者年龄≥ 18岁的流感和糖尿病。在诊断流感后1天内接受奥司他韦处方的患者与未接受抗病毒治疗的患者进行比较。结果包括肺炎、呼吸道疾病诊断、中耳炎及其并发症的频率，以及流感诊断后14天内的住院率。考克斯比例风险回归用于确定流感相关并发症和住院的相对风险（RR）。结果：共有9090例糖尿病患者和流感诊断符合所有研究标准。其中，2919例（32%）接受了奥司他韦处方，6171例（68%）未接受抗病毒治疗。接受奥司他韦治疗的患者呼吸系统疾病的风险显著降低17%（RR = 0.83; 95%CI，0.73-0.93），因任何原因住院的风险降低30%（RR = 0.70; 95%CI 0.52-0.94）。奥司他韦组和对照组在肺炎风险方面没有显著差异（RR = 0.87; 95%CI 0.64-1.18），中耳炎及其并发症（RR = 0.963 95% CI 0.48-1.91），或因肺炎住院（RR = 0.81; 95% CI 0.41-1.58）。在这项回顾性研究中，流感的风险-与未匹配的组相比，没有接受抗病毒治疗
Objective: This subgroup analysis of a retrospective cohort study examined, from a managed care perspective, the risk of influenza-related complications and hospitalizations in patients with diabetes who were prescribed oseltamivir for the treatment of influenza and those who were not prescribed antiviral treatment.Methods: Health insurance claims data from the Thomson Healthcare MarketScan Research Database for 6 influenza seasons (October 1-March 31) between 2000 and 2006 were used to identify patients aged >= 18 years with influenza and diabetes. Patients who received a prescription for oseltamivir within 1 day of a diagnosis of influenza were compared with those who received no antiviral treatment. Outcomes included the frequency of pneumonia, respiratory diagnoses, and otitis media and its complications, and rates of hospitalization within 14 days of the diagnosis of influenza. Cox proportional hazards regression was used to determine the relative risk (RR) of influenza-related complications and hospitalizations.Results: A total of 9090 patients with diabetes and a diagnosis of influenza were identified who met all study, criteria. Of these, 2919 (32%) received a prescription for oseltamivir and 6171 (68%) received no antiviral treatment. Patients receiving oseltamivir had a significant 17% reduction in the risk of respiratory illnesses (RR = 0.83; 95% CI, 0.73-0.93) and a 30% reduction in the risk of hospitalization for any reason (RR = 0.70; 95% CI 0.52-0.94). There were no significant differences between the oseltamivir and control groups in terms of the risks for pneumonia (RR = 0.87; 95% CI 0.64-1.18), otitis media and its complications (RR = 0.963 95% CI 0.48-1.91), or hospitalization for pneumonia (RR = 0.81; 95% CI 0.41-1.58).Conclusion: In this retrospective study, the risk of influenza-associated respiratory illnesses and the number of hospitalizations for any reason were reduced in patients with diabetes who were prescribed oseltamivir compared with an unmatched group that was not prescribed antiviral therapy.