Associations of oseltamivir with neuropsychiatric and behavioral adverse events: A systematic review and meta-analysis.

IF 2.9 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of managed care & specialty pharmacy Pub Date : 2025-10-01 DOI:10.18553/jmcp.2025.31.10.1051

Hye Su Jeong, Yeo Wool Lee, Taeho Greg Rhee, Sung Ryul Shim

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引用次数: 0

Abstract

Background: Influenza causes approximately 3-5 million severe cases and 290,000-650,000 deaths annually, and oseltamivir is considered the first-line pharmacotherapy. Recent reports on neuropsychiatric events (NPEs) associated with the use of oseltamivir necessitated a systematic safety profile review.

Objective: To systematically review and meta-synthesize the evidence on the associations of oseltamivir with adverse NPEs and behavioral events.

Methods: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed/Medline, Embase, and Cochrane Library databases from inception through October 31, 2024. Studies comparing oseltamivir with other control groups for NPEs were analyzed. Outcomes were categorized into (1) affective disorders, (2) neuropsychiatric symptoms, (3) anxiety disorders, (4) schizophrenic/psychotic disorders, and (5) suicide-related behaviors.

Results: 9 studies with 1,139-3,352,015 patients were identified. Oseltamivir significantly associated with a lower overall NPE incidence (risk ratio [RR] = 0.83; 95% CI = 0.72-0.97), except in patients younger than 20 years. Subgroup analyses showed significant association with a lower incidence risk in suicide attempts across all ages (RR = 0.60; 95% CI = 0.46-0.77) and in schizophrenia/psychotic disorders for patients younger than 20 years (RR = 0.75; 95% CI = 0.61-0.93).

Conclusions: This is the first comprehensive meta-analysis examining the associations of oseltamivir with various NPEs and behavioral adverse events, and we found no evidence supporting increased risks of these adverse events with oseltamivir use.

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奥司他韦与神经精神和行为不良事件的关联：系统回顾和荟萃分析。

背景：流感每年造成约300万至500万严重病例和29万至65万人死亡，奥司他韦被认为是一线药物治疗。最近关于与使用奥司他韦相关的神经精神事件（npe）的报道需要进行系统的安全性评估。目的：系统回顾和综合奥司他韦与不良NPEs和行为事件相关的证据。方法：我们使用PubMed/Medline、Embase和Cochrane图书馆数据库，从开始到2024年10月31日，按照系统评价和荟萃分析指南的首选报告项目进行了系统评价和荟萃分析。比较奥司他韦与其他对照组治疗npe的研究进行了分析。结果分为(1)情感障碍，(2)神经精神症状，(3)焦虑障碍，(4)精神分裂症/精神障碍，(5)自杀相关行为。结果：9项研究共纳入1139 - 3352015例患者。奥司他韦与较低的总体NPE发生率显著相关（风险比[RR] = 0.83; 95% CI = 0.72-0.97），年龄小于20岁的患者除外。亚组分析显示，所有年龄段的自杀企图发生率（RR = 0.60; 95% CI = 0.46-0.77）和20岁以下的精神分裂症/精神障碍患者（RR = 0.75; 95% CI = 0.61-0.93）与较低的发生率风险显著相关。结论：这是第一个全面的荟萃分析，研究了奥司他韦与各种npe和行为不良事件的关联，我们没有发现证据支持使用奥司他韦会增加这些不良事件的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of managed care & specialty pharmacy Health Professions-Pharmacy

CiteScore

3.50

自引率

4.80%

发文量

131

期刊介绍： JMCP welcomes research studies conducted outside of the United States that are relevant to our readership. Our audience is primarily concerned with designing policies of formulary coverage, health benefit design, and pharmaceutical programs that are based on evidence from large populations of people. Studies of pharmacist interventions conducted outside the United States that have already been extensively studied within the United States and studies of small sample sizes in non-managed care environments outside of the United States (e.g., hospitals or community pharmacies) are generally of low interest to our readership. However, studies of health outcomes and costs assessed in large populations that provide evidence for formulary coverage, health benefit design, and pharmaceutical programs are of high interest to JMCP’s readership.