Neuraminidase inhibitors for influenza.

  title={Neuraminidase inhibitors for influenza.},
  author={Anne Moscona},
  journal={The New England journal of medicine},
  volume={353 13},
  • A. Moscona
  • Published 29 September 2005
  • Medicine, Biology
  • The New England journal of medicine
he impact of influenza infection is felt globally each year when the disease develops in approximately 20 percent of the world’s population. In the United States, influenza infections occur in epidemics each winter, generally between late December and early March. Recent events, including human cases of avian influenza, have heightened awareness of the threat of a pandemic and have spurred efforts to develop plans for its control. Although vaccination is the primary strategy for the prevention… 

Figures and Tables from this paper

Adamantane resistance in influenza A.

The overwhelming majority of currently circulating influenza A(H3N2) viruses in the United States exhibit highlevel resistance to adamantanes due to an S31N (serine to asparagine at position 31) substitution in the viral M2 protein.

Neuraminidase Inhibitors and their Role in Avian and Pandemic Influenza

Efforts to optimize the use of neuraminidase inhibitor treatment in H5N1 disease are urgently needed and might eventually aid in the judicious use of stockpiled neuraminIDase inhibitors in the event of a pandemic.

The potential impact of neuraminidase inhibitor resistant influenza

Neuraminidase inhibitors, oseltamivir in particular, are the drugs of choice against seasonal influenza, zoonotic H5N1 and are stockpiled as the primary mitigating strategy for pandemic influenza containment and control.

Medical management of influenza infection.

  • A. Moscona
  • Medicine, Biology
    Annual review of medicine
  • 2008
Resistance to the NA inhibitors is now emerging, although at a level less significant than adamantane resistance, and this is a cause for concern if indeed some mutant strains of avian influenza are transmissible and pathogenic.

Influenza and Influenza Vaccine: A Review

Interventions that improve access to and uptake of the influenza vaccine must be initiated, targeting multiple levels, including health care policy, patients, health care systems, and the health care team.

Peramivir injection in the treatment of acute influenza: a review of the literature

Although anecdotal evidence supports the use of peramivir in pediatric patients, pregnant women, and hospitalized patients with severe influenza receiving continuous renal replacement therapy and extracorporeal membrane oxygenation, well-designed, controlled clinical trials should be conducted in order to assess its clinical efficacy in these patient populations.

Pandemics, Avian Influenza A (H5N1), and a Strategy for Pharmacists

Pharmacists are uniquely positioned to initiate near‐term practice changes that may positively impact both seasonal and potential pandemic morbidity and mortality and represent a treatment bridge until a pandemic‐specific vaccine is available.

Frontline defense against the next pandemic: Antivirals for avian flu

The spread of the virus and the challenges encountered in its management are discussed, along with a review on the antivirals against avian influenza, which remain the mainstay of management as they are well tolerated and less likely to promote the development of drug resistance.

Antivirals for Influenza

In addition to treating and preventing the initial burden of pediatric influenza infection, antiviral therapies may significantly reduce secondary bacterial infections, unnecessary antibiotic prescribing, and healthcare-associated costs.

Update on antivirals and vaccines for seasonal and potential pandemic use

There has been a renewed interest in the potential role of antivirals in the prevention and control of pandemic influenza.



Tackling the next influenza pandemic

“Ring” prophylaxis of close contacts with antivirals may be an effective strategy for preventing transmission of influenza in institutions and community settings, but technical constraints on vaccine production will limit the effectiveness of this measure in the first stages of the pandemic.

Avian Influenza: A New Pandemic Threat?

The current knowledge on avian influenza, including the virology, epidemiology, diagnosis, and management of this emerging disease, is summarized.

Perspectives on antiviral use during pandemic influenza.

  • F. Hayden
  • Medicine, Biology
    Philosophical transactions of the Royal Society of London. Series B, Biological sciences
  • 2001
There are antiviral drugs currently available that hold considerable promise for response to pandemic influenza before a vaccine is available, although considerable work remains in realizing this potential.

Pandemic Influenza: Is an Antiviral Response Realistic?

  • F. Hayden
  • Medicine
    The Pediatric infectious disease journal
  • 2004
Interpandemic studies demonstrate that the neuraminidase inhibitors would be effective for both prevention and treatment of influenza, and an effective antiviral response could not currently be launched in the United States.

A new millennium conundrum: how to use a powerful class of influenza anti-neuraminidase drugs (NAIs) in the community

Clinical and scientific experience need to be gained by using these inhibitors in the yearly conflagrations of epidemic influenza, which unchecked do great harm to communities.

Efficacy and safety of the neuraminidase inhibitor zanamivir in the treatment of influenzavirus infections

In adults with influenza A or B virus infections, direct administration of a selective neuraminidase inhibitor, zanamivir, to the respiratory tract is safe and reduces symptoms if begun early.

Role of neuraminidase in lethal synergism between influenza virus and Streptococcus pneumoniae.

It is demonstrated that the influenza virus NA potentiates development of pneumonia by stripping sialic acid from the lung, thus exposing receptors for pneumococcal adherence, and selective NA inhibitors may be useful clinically to interrupt this novel mechanism of synergism.

Transmissibility of 1918 pandemic influenza

An estimate of the reproductive number for 1918 pandemic influenza is obtained by fitting a deterministic SEIR (susceptible-exposed-infectious-recovered) model to pneumonia and influenza death epidemic curves from 45 US cities, which suggests that the median value is less than three.

Use of the oral neuraminidase inhibitor oseltamivir in experimental human influenza: randomized controlled trials for prevention and treatment.

In these trials, prophylaxis and early treatment with oral oseltamivir were both associated with significant antiviral and clinical effects in experimental human influenza.

Neuraminidase Sequence Analysis and Susceptibilities of Influenza Virus Clinical Isolates to Zanamivir and Oseltamivir

The baseline susceptibilities prior to and shortly after the introduction of the NA inhibitors are established and there was no evidence of naturally occurring resistance to either drug in any of the isolates.