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CompletedNCT01314911Updated Feb 5, 2019Results posted

Evaluating the Use of Oseltamivir for the Treatment of Influenza in Adults

An interventional study of Oseltamivir and Placebo in Influenza, Human, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 51 sites in 3 countries. Open to participants aged 18 Years to 64 Years. Per ClinicalTrials.gov, last updated 2019-02-05.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
716
Allocation
Randomized
Ages
18 Years to 64 Years
Sex
All
01

Study summary

People who are infected with the influenza virus may develop respiratory illnesses, such as pneumonia, or other life-threatening complications. Currently, there are four antiviral medications that are used to treat influenza. This study will examine one of these medications, oseltamivir, to examine how it affects the shedding of influenza virus in infected people.

Read the detailed description

Seasonal influenza is responsible for excess hospitalizations and, despite effective antivirals, causes significant morbidity and mortality (about 24,000 deaths each year in the United States alone). The influenza virus that emerged in 2009 (A/California/07/2009 H1N1) caused fewer deaths (12,000 flu-related deaths in the U.S.) but in contrast to seasonal flu, nearly 90% of the deaths with the 2009 H1N1 occurred among people younger than 65 years of age. Although there are four currently licensed anti-influenza medications (amantadine and rimantadine, oseltamivir, and zanamivir), previous studies have not demonstrated conclusively to what extent these medications affect influenza viral shedding. This study will evaluate whether oseltamivir modifies the viral shedding during the treatment of uncomplicated influenza in an adult population and also assess methods to detect viral replication in the upper respiratory tract.

Subjects who presented with an influenza-like illness without any risk factors for severe disease were screened for the study. Those with a confirmatory test for influenza (rapid antigen or polymerase chain reaction [PCR]) were randomized in a 1:1 manner to receive a blinded study treatment consisting of either the oseltamivir or placebo for 5 days. Clinical, virologic, and laboratory assessments on Days 1, 3, 7, and 28 were used for both safety and efficacy analysis.

02

Conditions studied

  • Influenza, Human

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Keywords

  • H1N1
  • Complications
  • PCR
  • Seasonal Influenza
  • Viral Shedding
03

In context

Influenza, Human

2,264 studies on the registry are indexed under Influenza, Human; 173 are open to participants now.

This study's enrollment of 716 is above the median of 240 across 1,894 interventional studies indexed under Influenza, Human.

Browse Influenza, Human studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,445 studies on the registry; 182 are open to participants now.

Of its 402 completed or terminated interventional studies of FDA-regulated products, 300 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 64 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Written informed consent prior to initiation of any study procedures
  • History of an influenza-like illness defined as:

    1) One or more respiratory symptom (cough, sore throat, or nasal symptoms)

  • Onset of illness no more than 48 hours before screening, defined as when the participant experienced at least one respiratory symptom
  • Willing to have samples stored
  • Positive test for influenza (either rapid antigen or polymerase chain reaction [PCR]); randomization could proceed in cases of discrepant results (one positive and one negative)

Exclusion criteria

Exclusion Criteria:

  • Hospitalization at the time of screening
  • Presence of a medical condition(s) that had been associated with increased risk of complications from influenza

    1. Aged 65 years of age or older
    2. Asthma
    3. Neurological and neuro-developmental conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle, such as cerebral palsy, epilepsy [seizure disorders], stroke, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury)
    4. Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] or cystic fibrosis)
    5. Heart disease (such as congenital heart disease, congestive heart failure, or coronary artery disease)
    6. Blood disorders
    7. Endocrine disorders (such as diabetes mellitus)
    8. Kidney disorders
    9. Liver disorders
    10. Metabolic disorders (such as inherited metabolic disorders or mitochondrial disorders)
    11. Weakened immune system due to disease or medication (such as people with HIV/AIDS or cancer, or use of chronic steroids or other medications causing immune suppression)
    12. Pregnant or 4 weeks postpartum
    13. Body mass index (BMI) greater than or equal to 40
  • Breastfeeding
  • Inability to take oral medication or a history of gastrointestinal malabsorption that would preclude the use of oral medication
  • Received more than one dose of any antiviral influenza medication since onset of influenza symptoms
  • Known end stage kidney dysfunction (e.g., creatinine clearance less than 30 mL/min)
  • Known hypersensitivity to oseltamivir, peramivir, or zanamivir
  • Received live attenuated influenza virus vaccine within 3 weeks prior to study entry
  • Use of any investigational drug within 30 days or 5 half-lives (whichever was longer) prior to study entry
  • Participated in other research protocols that required more than 100mL of blood to be drawn in a 4-week period that overlapped with this study.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
716 participants (actual)

Study arms

  • Experimental
    Oseltamivir

    Drug: Oseltamivir

  • Placebo comparator
    Placebo

    Drug: Placebo

Interventions

  • Subjects were prescribed Oseltamivir twice daily for 5 days, and each dose consisted of one capsule of Oseltamivir 75 mg.

  • DrugPlacebo

    Subjects were prescribed the matching placebo twice daily for 5 days, and each dose consisted of one capsule of placebo.

06

What researchers measure

Primary outcomes

  1. Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs at Day 3 -- Team Collected Samples

    The central laboratory performed a qualitative PCR test on the NP sample from Day 0 team collected swap in order to confirm influenza infection and to determine the influenza type and subtype. For participants with a positive influenza test result at Day 0 from this qualitative PCR testing, the laboratory then performed qPCR testing of subsequent samples to quantify viral shedding.

    Time frame: At Day 3

Secondary outcomes

  1. Number of Participants by Virus Detection Status--Team Collected Samples

    Number of participants who had undetectable values (less than the limit of detection \[LOD\]), who had values between the LOD and the lower limit of quantification (LLOQ), and who had values ≥LLOQ

    Time frame: At Day 0, 3 and 7

  2. qPCR Viral Shedding -- Team Collected Samples

    Median, 25% and 75% percentile of the value of viral shedding (Results \<LOD were imputed as the LOD value, and Results \>= LOD, \<LLOQ were imputed as the LLOQ value.)

    Time frame: At Day 0, 3 and 7

  3. Number Of Participants Shedding Virus -- Team Collected Samples

    Number of participants with undetectable viral load at both Day 3 and Day 7; detectable at Day 3 and undetectable at Day 7; detectable at Day 7 (irrespective of whether or not detectable at Day 3).

    Time frame: At day 3 and 7.

  4. Time to Alleviation of Influenza Clinical Symptoms

    The assessed symptoms were cough, nasal obstruction (stuffy nose), sore throat, fatigue, headache, muscle aches, feverishness, rhinorrhea, nausea, vomiting, diarrhea. Duration of clinical symptoms was defined as the time from Day 0 to the first of two successive measurements at which all clinical symptoms were grade 0 (absent) or 1 (mild). A measurement was considered to be the 8AM or 8PM assessment during Days 0 to 7 (so two measurements were obtained per day) and then the daily assessment thereafter. Time was calculated in half-days through to Day 7. If a subject's first two assessments on (baseline assessment and first subsequent diary card assessment) satisfied this criterion, then the duration was set to zero. For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with symptoms evaluated.

    Time frame: From treatment initiation to Day 28

  5. Time to Absence of Fever

    Fever was considered present based on the diary cards if a subject reported a maximal temperature ≥38.0°C (for the period since the diary card was previously completed) or reported having taken an antipyretic drug (also for the period since the diary card was previously completed). Otherwise, fever was considered not present during the period since the diary card was previously completed, except that the evaluation was considered missing if either the temperature or the antipyretic drug use entry was not completed on the diary card. The duration of fever was defined as the time from Day 0 to the first of two successive assessments (through to Day 7) or to the first assessment (Day 8 onwards) at which no fever was present according to this definition.For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with fever evaluated.

    Time frame: From treatment initiation to Day 28

  6. Time to Resolution of All Symptoms AND Fever

    The assessed symptoms were cough, nasal obstruction (stuffy nose), sore throat, fatigue, headache, muscle aches, feverishness, rhinorrhea, nausea, vomiting, diarrhea. Fever was considered present based on the diary cards if a subject reported a maximal temperature ≥38.0°C (for the period since the diary card was previously completed) or reported having taken an antipyretic drug (also for the period since the diary card was previously completed). Time to resolution of all clinical symptoms and fever is defined as the time from Day 0 to the first of two successive measurements at which all clinical symptoms are grade 0 (absent) or 1(mild) and no fever \>=38.0 C or antipyretic drug is reported. For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with symptoms and fever evaluated.

    Time frame: From treatment initiation to Day 28

  7. Time to Feeling as Good as Before the Onset of the Influenza Illness

    Time to feeling as good as before influenza is defined as time to the first of two successive 'yes' responses to the question of 'feeling as good as you did before you had the flu'.For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with question answered.

    Time frame: From treatment initiation to Day 28

  8. Time to Return to Pre-influenza Function

    Time to return to pre-influenza function is defined as the time from Day 0 to the first of two successive 'Yes' answers to the global assessment question 'Are you functioning as well as you were before you had the flu'.For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with question answered.

    Time frame: From treatment initiation to Day 28

  9. Time to Return of Physical Function to Pre-illness Level

    Time to return of physical function to pre-illness level was defined as the time from Day 0 to the first of two successive measurements at which the physical function score equals or is better than the pre-illness score (obtained by recall at enrollment). For subjects who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with physical function evaluated.

    Time frame: From treatment initiation to Day 28

  10. Number of Participants With Treatment Compliance Status

    For each of the 5 days of treatment, participants were asked whether they took all study drug for that day. All participants were assumed to have taken at least some study drug even if they had zero days with all study drug reported as taken. Missing reports for some or all days were imputed as not having taken all study drug for the days concerned.

    Time frame: From treatment initiation to Day 5

  11. Percentage of Participants Who Required Hospitalization.

    The percentage of participants hospitalized by 28 days was constructed by inverting an exact binomial test of the actual percentages (ignoring loss to follow-up).

    Time frame: From treatment initiation to Day 28

  12. Percentage of Participants Who Develop Bronchitis, Pneumonia, or Other Complications Requiring An Antibiotic Use, After Day 0.

    Participants were assessed for the signs/symptoms suggestive of one of the following complications: Sinusitis, Otitis Media ,Bronchitis / Bronchiolitis, Pneumonia and antibiotic use for reason other than above.

    Time frame: From treatment initiation to Day 28

  13. 28-day Mortality

    Number of deaths

    Time frame: From treatment initiation to Day 28

  14. Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs --Self Collected Samples

    For participants with a positive influenza test result at Day 0 from qualitative PCR testing on the team collected sample, the laboratory then performed qPCR testing of self-collected samples to quantify viral shedding.

    Time frame: At Day 3

  15. Number of Participants by Virus Detection Status --Self Collected Samples

    Number of participants who had undetectable values (less than the limit of detection \[LOD\]), who had values between the LOD and the lower limit of quantification (LLOQ), and who had values ≥LLOQ. Evening samples on Day 0, 1 and 2 were only required under protocol versions 1.0-4.0 and so were only collected for about 20% of participants.

    Time frame: At Day 0, Day 0 evening, Day 1, Day 1 evening, Day 2, Day 2 evening and Day 3

  16. qPCR Viral Shedding -- Self Collected Samples

    Median, 25% and 75% percentile of the value of viral shedding (Results \<LOD were imputed as the LOD value, and Results \>= LOD, \<LLOQ were imputed as the LLOQ value.). Evening samples on Day 0, 1 and 2 were only required under protocol versions 1.0-4.0 and so were only collected for about 20% of participants.

    Time frame: At Day 0, Day 0 evening, Day 1, Day 1 evening, Day 2, Day 2 evening and Day 3

  17. Area Under The Curve (AUC) Of Viral Shedding For Self Collected Samples

    This AUC was calculated using the trapezoidal rule and the units of measurement are (days\*log10 copies/mL) with the fact that it was the level of virus above the LLOQ being considered. The calculation of AUC was undertaken using measurements from Day 0 to Day 3 which were collected under all versions of the protocol (i.e. evening measurements on Days 0, 1 and 2 were not used as these were collected for only about 20% of subjects). Missing values during follow-up were ignored. This is equivalent to imputing a missing value using linear interpolation between the preceding and succeeding available values. For the five subjects with missing values following a last available measurement which was above the LLOQ, the remaining values were assumed to be the mean of preceding value and LLOQ in calculating the AUC.

    Time frame: From Day 0 to Day 3

07

Results

Posted Feb 5, 2019

Participant flow

Participants with an influenza-like illness and diagnosed with influenza by rapid antigen or PCR were recruited at 42 sites from 3 countries: 3 from Argentina, 4 from Thailand and 35 from the U.S., between January 2012 to October 2017.

Participant flow — Overall Study
MilestoneOseltamivirPlacebo
Started278280
Completed273274
Not completed56
Withdrew: Lost to follow-up32
Withdrew: Withdrawal by subject13
Withdrew: Received non-randomized study drug01
Withdrew: Never started treatment10

Outcome measures

PrimaryPercentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs at Day 3 -- Team Collected Samples

The central laboratory performed a qualitative PCR test on the NP sample from Day 0 team collected swap in order to confirm influenza infection and to determine the influenza type and subtype. For participants with a positive influenza test result at Day 0 from this qualitative PCR testing, the laboratory then performed qPCR testing of subsequent samples to quantify viral shedding.

Time frame:
At Day 3
Reported as:
Count of participants · Participants
Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs at Day 3 -- Team Collected Samples
ParticipantsOseltamivirPlacebo
Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs at Day 3 -- Team Collected Samples99131
Statistical analysis
  • Oseltamivir vs Placebo · Z-test, 2-sided · p = 0.0097 (P-value was not adjusted for multiple interim analyses.) · Mean difference (final values): -12.2 · 95% CI -21.4 to -3.0The difference in percents was calculated as the percent detectable in the Oseltamivir arm minus the percent detectable in the Placebo arm.
SecondaryNumber of Participants by Virus Detection Status--Team Collected Samples

Number of participants who had undetectable values (less than the limit of detection \[LOD\]), who had values between the LOD and the lower limit of quantification (LLOQ), and who had values ≥LLOQ

Time frame:
At Day 0, 3 and 7
Reported as:
Count of participants · Participants
Number of Participants by Virus Detection Status--Team Collected Samples
ParticipantsOseltamivirPlacebo
Day 0 — >= LLOQ237245
Day 0 — >= LOD, < LLOQ65
Day 0 — < LOD35
Day 0 — Missing00
Day 3 — >= LLOQ85109
Day 3 — >= LOD, < LLOQ2436
Day 3 — < LOD134107
Day 3 — Missing33
Day 7 — >= LLOQ1621
Day 7 — >= LOD, < LLOQ115
Day 7 — < LOD214224
Day 7 — Missing55
SecondaryqPCR Viral Shedding -- Team Collected Samples

Median, 25% and 75% percentile of the value of viral shedding (Results \<LOD were imputed as the LOD value, and Results \>= LOD, \<LLOQ were imputed as the LLOQ value.)

Time frame:
At Day 0, 3 and 7
Reported as:
Median · log10 copies/mL
qPCR Viral Shedding -- Team Collected Samples
log10 copies/mLOseltamivirPlacebo
Day 06.85 (5.8 to 7.6)6.9 (5.9 to 7.6)
Day 33.4 (3.2 to 4.5)3.9 (3.2 to 4.9)
Day 73.2 (3.2 to 3.4)3.2 (3.2 to 3.4)
SecondaryNumber Of Participants Shedding Virus -- Team Collected Samples

Number of participants with undetectable viral load at both Day 3 and Day 7; detectable at Day 3 and undetectable at Day 7; detectable at Day 7 (irrespective of whether or not detectable at Day 3).

Time frame:
At day 3 and 7.
Reported as:
Count of participants · Participants
Number Of Participants Shedding Virus -- Team Collected Samples
ParticipantsOseltamivirPlacebo
Undetectable at both Day 3 and 7126100
Detectable at Day 3 and undetectable at Day 787124
Detectable at Day 72726
Missing result at Day 3 and/or Day 765
Statistical analysis
  • Oseltamivir vs Placebo · Wilcoxon (Mann-Whitney) · p = 0.0243 (P-value was not adjusted for multiple interim analyses.)
SecondaryTime to Alleviation of Influenza Clinical Symptoms

The assessed symptoms were cough, nasal obstruction (stuffy nose), sore throat, fatigue, headache, muscle aches, feverishness, rhinorrhea, nausea, vomiting, diarrhea. Duration of clinical symptoms was defined as the time from Day 0 to the first of two successive measurements at which all clinical symptoms were grade 0 (absent) or 1 (mild). A measurement was considered to be the 8AM or 8PM assessment during Days 0 to 7 (so two measurements were obtained per day) and then the daily assessment thereafter. Time was calculated in half-days through to Day 7. If a subject's first two assessments on (baseline assessment and first subsequent diary card assessment) satisfied this criterion, then the duration was set to zero. For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with symptoms evaluated.

Time frame:
From treatment initiation to Day 28
Reported as:
Median · days
Time to Alleviation of Influenza Clinical Symptoms
daysOseltamivirPlacebo
Time to Alleviation of Influenza Clinical Symptoms4 (3.5 to 4.5)4 (3.5 to 4.5)
Statistical analysis
  • Oseltamivir vs Placebo · Log Rank · p = 0.41 (P-value was not adjusted for multiple interim analyses.)
SecondaryTime to Absence of Fever

Fever was considered present based on the diary cards if a subject reported a maximal temperature ≥38.0°C (for the period since the diary card was previously completed) or reported having taken an antipyretic drug (also for the period since the diary card was previously completed). Otherwise, fever was considered not present during the period since the diary card was previously completed, except that the evaluation was considered missing if either the temperature or the antipyretic drug use entry was not completed on the diary card. The duration of fever was defined as the time from Day 0 to the first of two successive assessments (through to Day 7) or to the first assessment (Day 8 onwards) at which no fever was present according to this definition.For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with fever evaluated.

Time frame:
From treatment initiation to Day 28
Reported as:
Median · days
Time to Absence of Fever
daysOseltamivirPlacebo
Time to Absence of Fever1 (0.5 to 1.0)1 (0.5 to 1.0)
Statistical analysis
  • Oseltamivir vs Placebo · Log Rank · p = 0.88 (P-value was not adjusted for multiple interim analyses.)
SecondaryTime to Resolution of All Symptoms AND Fever

The assessed symptoms were cough, nasal obstruction (stuffy nose), sore throat, fatigue, headache, muscle aches, feverishness, rhinorrhea, nausea, vomiting, diarrhea. Fever was considered present based on the diary cards if a subject reported a maximal temperature ≥38.0°C (for the period since the diary card was previously completed) or reported having taken an antipyretic drug (also for the period since the diary card was previously completed). Time to resolution of all clinical symptoms and fever is defined as the time from Day 0 to the first of two successive measurements at which all clinical symptoms are grade 0 (absent) or 1(mild) and no fever \>=38.0 C or antipyretic drug is reported. For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with symptoms and fever evaluated.

Time frame:
From treatment initiation to Day 28
Reported as:
Median · days
Time to Resolution of All Symptoms AND Fever
daysOseltamivirPlacebo
Time to Resolution of All Symptoms AND Fever4.0 (3.5 to 4.5)4.0 (3.5 to 4.5)
Statistical analysis
  • Oseltamivir vs Placebo · Log Rank · p = 0.7461 (P-value was not adjusted for multiple interim analyses.)
SecondaryTime to Feeling as Good as Before the Onset of the Influenza Illness

Time to feeling as good as before influenza is defined as time to the first of two successive 'yes' responses to the question of 'feeling as good as you did before you had the flu'.For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with question answered.

Time frame:
From treatment initiation to Day 28
Reported as:
Median · days
Time to Feeling as Good as Before the Onset of the Influenza Illness
daysOseltamivirPlacebo
Time to Feeling as Good as Before the Onset of the Influenza Illness6.0 (5.0 to 6.5)6.0 (5.5 to 6.5)
Statistical analysis
  • Oseltamivir vs Placebo · Log Rank · p = 0.1501 (P-value was not adjusted for multiple interim analyses.)
SecondaryTime to Return to Pre-influenza Function

Time to return to pre-influenza function is defined as the time from Day 0 to the first of two successive 'Yes' answers to the global assessment question 'Are you functioning as well as you were before you had the flu'.For participants who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with question answered.

Time frame:
From treatment initiation to Day 28
Reported as:
Median · days
Time to Return to Pre-influenza Function
daysOseltamivirPlacebo
Time to Return to Pre-influenza Function3.5 (3.5 to 4.5)5.0 (4.0 to 5.0)
Statistical analysis
  • Oseltamivir vs Placebo · Log Rank · p = 0.3025 (P-value was not adjusted for multiple interim analyses.)
SecondaryTime to Return of Physical Function to Pre-illness Level

Time to return of physical function to pre-illness level was defined as the time from Day 0 to the first of two successive measurements at which the physical function score equals or is better than the pre-illness score (obtained by recall at enrollment). For subjects who did not have two successive records meeting this criterion, follow-up was censored for analysis purposes at the time of the last but one diary card record with physical function evaluated.

Time frame:
From treatment initiation to Day 28
Reported as:
Median · days
Time to Return of Physical Function to Pre-illness Level
daysOseltamivirPlacebo
Time to Return of Physical Function to Pre-illness Level7.0 (6.0 to 8.0)7.0 (6.0 to 7.0)
Statistical analysis
  • Oseltamivir vs Placebo · Log Rank · p = 0.5466 (P-value was not adjusted for multiple interim analyses.)
SecondaryNumber of Participants With Treatment Compliance Status

For each of the 5 days of treatment, participants were asked whether they took all study drug for that day. All participants were assumed to have taken at least some study drug even if they had zero days with all study drug reported as taken. Missing reports for some or all days were imputed as not having taken all study drug for the days concerned.

Time frame:
From treatment initiation to Day 5
Reported as:
Count of participants · Participants
Number of Participants With Treatment Compliance Status
ParticipantsOseltamivirPlacebo
0 day with all study drug reported as taken12
1 day with all study drug reported as taken22
3 days with all study drug reported as taken21
4 days with all study drug reported as taken21
5 days with all study drug reported as taken270273
SecondaryPercentage of Participants Who Required Hospitalization.

The percentage of participants hospitalized by 28 days was constructed by inverting an exact binomial test of the actual percentages (ignoring loss to follow-up).

Time frame:
From treatment initiation to Day 28
Reported as:
Number · percentage of participants
Percentage of Participants Who Required Hospitalization.
percentage of participantsOseltamivirPlacebo
Percentage of Participants Who Required Hospitalization.1.4 (0.4 to 3.7)0.7 (0.1 to 2.6)
Statistical analysis
  • Oseltamivir vs Placebo · two-sample binomial exact test · p = 0.5311 (P-value was not adjusted for multiple interim analyses.) · Mean difference (final values): 0.7 · 95% CI -1.4 to 3.0The difference in percents was calculated as the percent in the Oseltamivir arm minus the percent in the placebo arm.
SecondaryPercentage of Participants Who Develop Bronchitis, Pneumonia, or Other Complications Requiring An Antibiotic Use, After Day 0.

Participants were assessed for the signs/symptoms suggestive of one of the following complications: Sinusitis, Otitis Media ,Bronchitis / Bronchiolitis, Pneumonia and antibiotic use for reason other than above.

Time frame:
From treatment initiation to Day 28
Reported as:
Number · percentage of participants
Percentage of Participants Who Develop Bronchitis, Pneumonia, or Other Complications Requiring An Antibiotic Use, After Day 0.
percentage of participantsOseltamivirPlacebo
Sinusitis3.21.8
Otitis Media0.40.4
Bronchitis Bronchiolitis2.52.2
Pneumonia0.40.4
Antibiotic use2.53.6
If have at least one Complication7.26.8
Statistical analysis
  • Oseltamivir vs Placebo · Z test · p = 0.8498 (P-value was not adjusted for multiple interim analyses.) · Mean difference (final values): 0.4 · 95% CI -3.8 to 4.7The difference in percents was calculated as the percent in the Oseltamivir arm minus the percent in the placebo arm.
Secondary28-day Mortality

Number of deaths

Time frame:
From treatment initiation to Day 28
Reported as:
Count of participants · Participants
28-day Mortality
ParticipantsOseltamivirPlacebo
28-day Mortality00
SecondaryPercentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs --Self Collected Samples

For participants with a positive influenza test result at Day 0 from qualitative PCR testing on the team collected sample, the laboratory then performed qPCR testing of self-collected samples to quantify viral shedding.

Time frame:
At Day 3
Reported as:
Count of participants · Participants
Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs --Self Collected Samples
ParticipantsOseltamivirPlacebo
Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs --Self Collected Samples5689
Statistical analysis
  • Oseltamivir vs Placebo · Z test · p = 0.0021 (P-value was not adjusted for multiple interim analyses.) · Mean difference (final values): -13.6 · 95% CI -22.2 to -5.1
SecondaryNumber of Participants by Virus Detection Status --Self Collected Samples

Number of participants who had undetectable values (less than the limit of detection \[LOD\]), who had values between the LOD and the lower limit of quantification (LLOQ), and who had values ≥LLOQ. Evening samples on Day 0, 1 and 2 were only required under protocol versions 1.0-4.0 and so were only collected for about 20% of participants.

Time frame:
At Day 0, Day 0 evening, Day 1, Day 1 evening, Day 2, Day 2 evening and Day 3
Reported as:
Count of participants · Participants
Number of Participants by Virus Detection Status --Self Collected Samples
ParticipantsOseltamivirPlacebo
Day 0 — >= LLOQ217225
Day 0 — >= LOD, < LLOQ116
Day 0 — < LOD1723
Day 0 — Missing11
Day 0 evening — >= LLOQ3748
Day 0 evening — >= LOD, < LLOQ41
Day 0 evening — < LOD85
Day 0 evening — Missing197201
Day 1 — >= LLOQ138147
Day 1 — >= LOD, < LLOQ3027
Day 1 — < LOD7576
Day 1 — Missing35
Day 1 evening — >= LLOQ2329
Day 1 evening — >= LOD, < LLOQ49
Day 1 evening — < LOD2413
Day 1 evening — Missing195204
Day 2 — >= LLOQ7092
Day 2 — >= LOD, < LLOQ2631
Day 2 — < LOD146129
Day 2 — Missing43
Day 2 evening — >= LLOQ1112
Day 2 evening — >= LOD, < LLOQ64
Day 2 evening — < LOD3241
Day 2 evening — Missing197198
Day 3 — >= LLOQ3965
Day 3 — >= LOD, < LLOQ2535
Day 3 — < LOD178149
Day 3 — Missing46
SecondaryqPCR Viral Shedding -- Self Collected Samples

Median, 25% and 75% percentile of the value of viral shedding (Results \<LOD were imputed as the LOD value, and Results \>= LOD, \<LLOQ were imputed as the LLOQ value.). Evening samples on Day 0, 1 and 2 were only required under protocol versions 1.0-4.0 and so were only collected for about 20% of participants.

Time frame:
At Day 0, Day 0 evening, Day 1, Day 1 evening, Day 2, Day 2 evening and Day 3
Reported as:
Median · log10 copies/mL
qPCR Viral Shedding -- Self Collected Samples
log10 copies/mLOseltamivirPlacebo
Day 06.1 (4.9 to 6.9)6.2 (5.4 to 6.9)
Day 0 evening5.5 (4.3 to 6.2)6.0 (5.0 to 6.6)
Day 14.2 (3.4 to 5.5)4.5 (3.4 to 5.9)
Day 1 evening3.9 (3.2 to 7.2)4.0 (3.4 to 5.6)
Day 23.4 (3.2 to 4.3)3.4 (3.2 to 4.8)
Day 2 evening3.2 (3.2 to 3.9)3.2 (3.2 to 3.9)
Day 33.2 (3.2 to 3.9)3.4 (3.2 to 4.0)
SecondaryArea Under The Curve (AUC) Of Viral Shedding For Self Collected Samples

This AUC was calculated using the trapezoidal rule and the units of measurement are (days\*log10 copies/mL) with the fact that it was the level of virus above the LLOQ being considered. The calculation of AUC was undertaken using measurements from Day 0 to Day 3 which were collected under all versions of the protocol (i.e. evening measurements on Days 0, 1 and 2 were not used as these were collected for only about 20% of subjects). Missing values during follow-up were ignored. This is equivalent to imputing a missing value using linear interpolation between the preceding and succeeding available values. For the five subjects with missing values following a last available measurement which was above the LLOQ, the remaining values were assumed to be the mean of preceding value and LLOQ in calculating the AUC.

Time frame:
From Day 0 to Day 3
Reported as:
Median · days*log10 copies/mL
Area Under The Curve (AUC) Of Viral Shedding For Self Collected Samples
days*log10 copies/mLOseltamivirPlacebo
Area Under The Curve (AUC) Of Viral Shedding For Self Collected Samples12.5 (11.35 to 14.55)13.18 (11.55 to 15.75)
Statistical analysis
  • Oseltamivir vs Placebo · Wilcoxon (Mann-Whitney) · p = 0.022 (P-value was not adjusted for multiple interim analyses.)

Adverse events

Collected over Adverse events were collected throughout the conduct of the study; from Day 0 to Day 28. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Oseltamivir0/277 (0%)5/277 (1.8%)134/277 (48.4%)
Placebo0/279 (0%)2/279 (0.7%)153/279 (54.8%)
Most frequent serious events
Most frequent serious events
EventOseltamivirPlacebo
InfluenzaInfections and infestations2/2771/279
SinusitisInfections and infestations1/2770/279
VomitingGastrointestinal disorders1/2770/279
Abortion spontaneousPregnancy, puerperium and perinatal conditions1/2770/279
Chest painGeneral disorders0/2771/279
Most frequent other events
Showing 10 of 13
Most frequent other events
EventOseltamivirPlacebo
NauseaGastrointestinal disorders65/27761/279
DiarrhoeaGastrointestinal disorders41/27747/279
VomitingGastrointestinal disorders35/27736/279
CoughRespiratory, thoracic and mediastinal disorders28/27732/279
PyrexiaGeneral disorders31/27727/279
HeadacheNervous system disorders28/27724/279
RhinorrhoeaRespiratory, thoracic and mediastinal disorders26/27723/279
FatigueGeneral disorders24/27726/279
Oropharyngeal painRespiratory, thoracic and mediastinal disorders24/27725/279
DizzinessNervous system disorders22/27715/279

Baseline characteristics

The population analyzed is the Intention To Treat (ITT) Population, which included all participants who were randomized properly and who had received at least one dose of study drug.

Age, Categorical
Age, Categorical(Participants)OseltamivirPlaceboTotal
<=18 years6612
Between 18 and 65 years271273544
>=65 years000
Age, Continuous
Age, Continuous(years)OseltamivirPlaceboTotal
Median37 (27 to 49)35 (27 to 46)36 (27 to 47)
Sex: Female, Male
Sex: Female, Male(Participants)OseltamivirPlaceboTotal
Female183164347
Male94115209
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)OseltamivirPlaceboTotal
Hispanic or Latino111324
Not Hispanic or Latino265266531
Unknown or Not Reported101
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)OseltamivirPlaceboTotal
Race — Asian193192385
Race — White7476150
Race — Black or African American71118
Race — Race not available to clinic101
Race — Subject does not know101
Race — Subject does not want to report101
Region of Enrollment
Region of Enrollment(participants)OseltamivirPlaceboTotal
Argentina4812
United States9187178
Thailand182184366
Confirmed influenza infection status by central testing
Confirmed influenza infection status by central testing(Participants)OseltamivirPlaceboTotal
Count of participants246255501
Influenza type/subtype by central testing
Influenza type/subtype by central testing(Participants)OseltamivirPlaceboTotal
Influenza A/H3N2122129251
Influenza A/H1N1395493
Influenza B8571156
Negative302252
Co-infection011
Missing123

13 further baseline measures are reported on the registry.

08

Study locations

51 sites
  • East Valley Family Physicians
    Chandler, Arizona 85224, United States
  • WCCT Global, LLC
    Costa Mesa, California 92626, United States
  • Paragon Rx Clinical
    Garden Grove, California 92840, United States
  • University of Southern California
    Los Angeles, California 92103, United States
  • University of California, San Diego
    San Diego, California 92103, United States
  • Westlake Medical Research
    Thousand Oaks, California 91360, United States
  • Advanced Rx Clinical Research Group
    Westminster, California 92683, United States
  • University of Colorado
    Aurora, Colorado 80045, United States
  • University of Florida
    Gainesville, Florida 32610-0186, United States
  • Best Quality Research, Inc.
    Hialeah, Florida 33106, United States
  • Medical Consulting Center
    Miami, Florida 33125, United States
  • Suncoast Research Group, LLC
    Miami, Florida 33135, United States
  • DMI Research, Inc.
    Pinellas Park, Florida 33782, United States
  • Columbus Regional Research Institute
    Columbus, Georgia 31904, United States
  • University of Iowa
    Iowa City, Iowa 52242, United States
  • Research Integrity, LLC
    Owensboro, Kentucky 42303, United States
  • Horizon Research Group of Opelousas, LLC
    Eunice, Louisiana 70535, United States
  • Michael Seep, MD; Centex Studies
    Lake Charles, Louisiana 70601, United States
  • National Institutes of Health, Laboratory of Immunoregulation
    Bethesda, Maryland 20892, United States
  • Brigham and Women's Hospital
    Boston, Massachusetts 02115, United States
  • Skyline Medical Center
    Elkhorn, Nebraska 68022, United States
  • Prairie Fields Family Medicine
    Fremont, Nebraska 68025, United States
  • Southwest Family Physicians
    Omaha, Nebraska 68124, United States
  • Clinical Research Advantage, Inc.
    Omaha, Nebraska 68144, United States
  • New Jersey Medical School
    Newark, New Jersey 07103, United States
  • NYU School of Medicine
    New York, New York 10016, United States
  • Mount Sinai Medical Center
    New York, New York 10029, United States
  • University of Rochester Medical Center
    Rochester, New York 14642, United States
  • Great Lakes Medical Research
    Westfield, New York 14787, United States
  • Clinical Research Solutions
    Middleburg Heights, Ohio 44130, United States
  • University of Pennsylvania, Division of Infectious Disease
    Philadelphia, Pennsylvania 19104, United States
  • Frontier Clinical Research, LLC
    Smithfield, Pennsylvania 15478, United States
  • Health Concepts
    Rapid City, South Dakota 57702, United States
  • Clinical Research Solutions
    Franklin, Tennessee 37067, United States
  • Clinical Research Solutions
    Jackson, Tennessee 38305, United States
  • Clinical Research Solutions
    Nashville, Tennessee 37211, United States
  • Clinical Research Solutions
    Smyrna, Tennessee 37167, United States
  • University of Texas Tech Amarillo
    Amarillo, Texas 79106, United States
  • University of Texas Health Science Center at Houston
    Houston, Texas 77030, United States
  • Centex Studies
    Houston, Texas 77058, United States
  • Texas Tech University Health Sciences Center
    Lubbock, Texas 79430, United States
  • Village Health Partners
    Plano, Texas 75024, United States
  • Bandera Family Health Care
    San Antonio, Texas 78249, United States
  • Virginia Commonwealth University Medical Center
    Richmond, Virginia 23298, United States
  • Hospital General de Agudos J. M. Ramos Mejía
    Buenos Aires, Argentina
  • Hospital Municipal "Prof. Dr. Bernardo A. Houssay"
    Buenos Aires, Argentina
  • Hospital Público Descentralizado Dr. Guillermo Rawson
    Córdoba, 05000, Argentina
  • The Bamrasnaradura Infectious Diseases Institute
    Nonthaburi, Changwat Nonthaburi 1100, Thailand
  • The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT)
    Bangkok, 10330, Thailand
  • Siriraj Hospital
    Bangkok, 10700, Thailand
  • Khon Kaen University (Department of Medicine)
    Khon Kaen, 40002, Thailand
09

References and documents

Publications

  • Thompson WW, Shay DK, Weintraub E, Brammer L, Cox N, Anderson LJ, Fukuda K. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003 Jan 8;289(2):179-86. doi: 10.1001/jama.289.2.179. PubMed 12517228 ↗
  • Monto AS. Vaccines and antiviral drugs in pandemic preparedness. Emerg Infect Dis. 2006 Jan;12(1):55-60. doi: 10.3201/eid1201.051068. PubMed 16494718 ↗
  • Beigel JH, Manosuthi W, Beeler J, Bao Y, Hoppers M, Ruxrungtham K, Beasley RL, Ison M, Avihingsanon A, Losso MH, Langlois N, Hoopes J, Lane HC, Holley HP, Myers CA, Hughes MD, Davey RT. Effect of Oral Oseltamivir on Virological Outcomes in Low-risk Adults With Influenza: A Randomized Clinical Trial. Clin Infect Dis. 2020 May 23;70(11):2317-2324. doi: 10.1093/cid/ciz634. PubMed 31541242 ↗

Study documents

  • Statistical analysis plan · Aug 3, 2016
  • Study protocol · Aug 3, 2016

Documents are hosted by the registry — open the source record to download them.

10

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Apr 2011, a primary completion of Nov 2017 and a completion of Nov 2017. It does not say whether these dates are actual or estimated.

Results were first posted in Feb 2019, 1 year 2 months after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 3, 2011
First posted
Mar 15, 2011
Start
Apr 2011
Primary completionActual
Nov 18, 2017
CompletionActual
Nov 18, 2017
Results first posted
Feb 5, 2019
Last update
Feb 5, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 5, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01314911
Responsible party
Sponsor
First posted
Mar 15, 2011
Start date
Apr 2011
Primary completion
Nov 18, 2017
Completion
Nov 18, 2017
Results posted
Feb 5, 2019
Last update
Feb 5, 2019

Study contacts

John Beigel, MD
study chair · Leidos Biomedical Research, Inc. in support of Clinical Research Section, LIR, NIAID, National Institutes of Health
Michael Ison, MD, MS
study chair · Division of Infectious Disease, Feinberg School of Medicine, Northwestern University

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2019. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Oseltamivir

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