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Influenza, HumanNCT01314911

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

A study testing Oseltamivir in people with Influenza, Human, run by National Institute of Allergy and Infectious Diseases (NIAID) at 51 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Influenza, Human
What is being tested?
Oseltamivir
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
716 participants
Where
51 sitesin 3 countries
Study dates
Apr 2011to 18 Nov 2017
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • 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)

Who cannot join

  • Hospitalization at the time of screening
  • Presence of a medical condition(s) that had been associated with increased risk of complications from influenza
  • Aged 65 years of age or older
  • Asthma
  • 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)
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] or cystic fibrosis)
Show all 23Show fewer
  • Heart disease (such as congenital heart disease, congestive heart failure, or coronary artery disease)
  • Blood disorders
  • Endocrine disorders (such as diabetes mellitus)
  • Kidney disorders
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders or mitochondrial disorders)
  • 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)
  • Pregnant or 4 weeks postpartum
  • 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.

Trial locations and contacts

51 sites in 3 countries.

51 sites in 3 countries

United States44 sites
  • University of Texas Tech Amarillo

    Amarillo, Texas, 79106

  • University of Colorado

    Aurora, Colorado, 80045

  • National Institutes of Health, Laboratory of Immunoregulation

    Bethesda, Maryland, 20892

  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • East Valley Family Physicians

    Chandler, Arizona, 85224

  • Columbus Regional Research Institute

    Columbus, Georgia, 31904

  • WCCT Global, LLC

    Costa Mesa, California, 92626

  • Skyline Medical Center

    Elkhorn, Nebraska, 68022

  • Horizon Research Group of Opelousas, LLC

    Eunice, Louisiana, 70535

  • Clinical Research Solutions

    Franklin, Tennessee, 37067

  • Prairie Fields Family Medicine

    Fremont, Nebraska, 68025

  • University of Florida

    Gainesville, Florida, 32610-0186

  • Paragon Rx Clinical

    Garden Grove, California, 92840

  • Best Quality Research, Inc.

    Hialeah, Florida, 33106

  • University of Texas Health Science Center at Houston

    Houston, Texas, 77030

  • Centex Studies

    Houston, Texas, 77058

  • University of Iowa

    Iowa City, Iowa, 52242

  • Clinical Research Solutions

    Jackson, Tennessee, 38305

  • Michael Seep, MD; Centex Studies

    Lake Charles, Louisiana, 70601

  • University of Southern California

    Los Angeles, California, 92103

  • Texas Tech University Health Sciences Center

    Lubbock, Texas, 79430

  • Medical Consulting Center

    Miami, Florida, 33125

  • Suncoast Research Group, LLC

    Miami, Florida, 33135

  • Clinical Research Solutions

    Middleburg Heights, Ohio, 44130

  • Clinical Research Solutions

    Nashville, Tennessee, 37211

  • NYU School of Medicine

    New York, New York, 10016

  • Mount Sinai Medical Center

    New York, New York, 10029

  • New Jersey Medical School

    Newark, New Jersey, 07103

  • Southwest Family Physicians

    Omaha, Nebraska, 68124

  • Clinical Research Advantage, Inc.

    Omaha, Nebraska, 68144

  • Research Integrity, LLC

    Owensboro, Kentucky, 42303

  • University of Pennsylvania, Division of Infectious Disease

    Philadelphia, Pennsylvania, 19104

  • DMI Research, Inc.

    Pinellas Park, Florida, 33782

  • Village Health Partners

    Plano, Texas, 75024

  • Health Concepts

    Rapid City, South Dakota, 57702

  • Virginia Commonwealth University Medical Center

    Richmond, Virginia, 23298

  • University of Rochester Medical Center

    Rochester, New York, 14642

  • Bandera Family Health Care

    San Antonio, Texas, 78249

  • University of California, San Diego

    San Diego, California, 92103

  • Frontier Clinical Research, LLC

    Smithfield, Pennsylvania, 15478

  • Clinical Research Solutions

    Smyrna, Tennessee, 37167

  • Westlake Medical Research

    Thousand Oaks, California, 91360

  • Great Lakes Medical Research

    Westfield, New York, 14787

  • Advanced Rx Clinical Research Group

    Westminster, California, 92683

Other trials in United States

Thailand4 sites
  • The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT)

    Bangkok, 10330

  • Siriraj Hospital

    Bangkok, 10700

  • Khon Kaen University (Department of Medicine)

    Khon Kaen, 40002

  • The Bamrasnaradura Infectious Diseases Institute

    Nonthaburi, Changwat Nonthaburi, 1100

Other trials in Thailand

Argentina3 sites
  • Hospital General de Agudos J. M. Ramos Mejía

    Buenos Aires

  • Hospital Municipal "Prof. Dr. Bernardo A. Houssay"

    Buenos Aires

  • Hospital Público Descentralizado Dr. Guillermo Rawson

    Córdoba, 05000

Other trials in Argentina

About this study

Official title: A Randomized Double-Blind Study Comparing Oseltamivir Versus Placebo for the Treatment of Influenza in Low Risk Adults

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.

Being tested
Oseltamivir, Placebo
Keywords
H1N1, Complications, PCR, Seasonal Influenza, Viral Shedding
Medical subject headings
Influenza, Human

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • OseltamivirDrug

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

  • PlaceboDrug

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

Study groups in NCT01314911
Study groupRoleWhat they receive
OseltamivirExperimentalNot described
Receives: Drug: Oseltamivir
PlaceboPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  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.

    Measured: At Day 3

Secondary outcomes (17)
  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

    Measured: 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.)

    Measured: 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).

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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).

    Measured: 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.

    Measured: From treatment initiation to Day 28

  13. 28-day Mortality

    Number of deaths

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: 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.

    Measured: From Day 0 to Day 3

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Mar 2011 (estimated)
  2. Study startApr 2011
  3. Primary completion18 Nov 2017
  4. Study completion18 Nov 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
716 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01314911
Sponsor's protocol ID
IRC 004
Other IDs
11-I-0031, IRC004
Status last verified
Jan 2019
First submitted
3 Mar 2011
Last updated
5 Feb 2019
Data monitoring committee
Yes

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

Questions about this trial

What is this clinical trial studying?

A study testing Oseltamivir in people with Influenza, Human, run by National Institute of Allergy and Infectious Diseases (NIAID) at 51 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 23 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 51 sites in United States, Thailand, Argentina. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 5 Feb 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With Virus Detectable by Quantitative PCR (qPCR) in Nasopharyngeal (NP) Swabs at Day 3 -- Team Collected Samples (time frame: At Day 3). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01314911, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Feb 2019.

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