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Association between Maoto Use and Hospitalization for Seasonal Influenza in a Nonelderly Cohort in Japan.

Abstract
Objective Maoto is a traditional Japanese Kampo formula used to treat influenza. However, clinical evidence for maoto has been limited to small-scale studies of its effect in alleviating symptoms. The present study evaluated whether or not the addition of maoto to a neuraminidase inhibitor was associated with a reduction in hospitalization following influenza. Methods Using the JMDC Claims Database, we identified outpatients <60 years old who were diagnosed with influenza by an antigen test from September 2013 to August 2018. One-to-five propensity score matching was conducted between patients who received maoto in addition to a neuraminidase inhibitor and those who received a neuraminidase inhibitor alone. Hospitalization within seven days of the influenza diagnosis was compared in the matched groups using the Mantel-Haenszel test. Results We identified 1.79 million cases of influenza from the database in the 5-year study period. Maoto was prescribed for 3.9% of the 1.67 million cases receiving a neuraminidase inhibitor. In the 64,613 propensity score-matched groups of patients, the 7-day hospitalization rate was 0.116% (n=75) for patients with maoto and 0.122% (n=394) for patients without maoto. The difference between these treatment groups was nonsignificant (common odds ratio, 0.95; 95% confidence interval, 0.74 to 1.22; p=0.695). Conclusion The addition of maoto to a neuraminidase inhibitor was not associated with a decrease in hospitalization among nonelderly patients with influenza. Further research is necessary to clarify the indication and efficacy of maoto.
AuthorsHayato Yamana, Sachiko Ono, Nobuaki Michihata, Taisuke Jo, Hideo Yasunaga
JournalInternal medicine (Tokyo, Japan) (Intern Med) Vol. 60 Issue 21 Pg. 3401-3408 ( 2021) ISSN: 1349-7235 [Electronic] Japan
PMID34719625 (Publication Type: Journal Article)
Chemical References
  • Antiviral Agents
  • Oseltamivir
  • Neuraminidase
Topics
  • Antiviral Agents (therapeutic use)
  • Hospitalization
  • Humans
  • Influenza, Human (diagnosis, drug therapy, epidemiology)
  • Japan (epidemiology)
  • Medicine, Kampo
  • Middle Aged
  • Neuraminidase
  • Oseltamivir (therapeutic use)
  • Seasons

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