Chuang Pei-Hua, Tzang Bor-Show, Tzang Chih-Chen, Kuo I-Ying, Lin Chun-Yu, Hsu Tsai-Ching
Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.
Pharmaceuticals (Basel). 2025 May 26;18(6):796. doi: 10.3390/ph18060796.
: Evidence has indicated an increased risk of stroke in individuals with influenza infection, and the administration of Oseltamivir revealed a lower stroke risk in these individuals. However, the impacts of Oseltamivir and stroke remain limited. : The data used in this retrospective cohort study were extracted from the Taiwan National Health Insurance Research Database (NHIRD), which included 281,420 Oseltamivir users and 13,394,652 patients between 1 January 2009 and 31 December 2018. The Oseltamivir group was younger (age 40.1 ± 15.3 years) and had a lower prevalence of comorbidities compared to the non-user group (age 46.2 ± 16.0 years). Stroke incidence and mortality were compared using multivariable Cox proportional hazards models. : We compared the incidence of ischemic stroke among individuals without a history of ischemic stroke, stratified by Oseltamivir use. After adjusting for age, sex, and comorbidities, Oseltamivir use was not associated with a significantly different risk of stroke (adjusted HR = 1.02, 95% CI: 0.96-1.08; = 0.511). The mortality among individuals with a history of ischemic stroke, being Oseltamivir users (n = 2502), exhibited a lower cumulative mortality rate compared to non-users (4.08% vs. 6.45%). The association remained significant after multivariable adjustment, with an adjusted hazard ratio for mortality of 0.74 (95% CI: 0.61-0.89; = 0.002). In this large population-based cohort of patients without a history of ischemic stroke, Oseltamivir use during influenza infection was not associated with stroke incidence after adjusting for age, sex, and comorbidities. Notably, Oseltamivir use in patients with a history of ischemic stroke was associated with reduced all-cause mortality, suggesting a potential survival benefit that warrants further investigation.
有证据表明，流感感染个体的中风风险增加，而服用奥司他韦可降低这些个体的中风风险。然而，奥司他韦与中风之间的影响仍较为有限。：本回顾性队列研究中使用的数据来自台湾国民健康保险研究数据库（NHIRD），该数据库包括2009年1月1日至2018年12月31日期间的281,420名奥司他韦使用者和13,394,652名患者。与非使用者组（年龄46.2±16.0岁）相比，奥司他韦组更年轻（年龄40.1±15.3岁），合并症患病率更低。使用多变量Cox比例风险模型比较中风发病率和死亡率。：我们比较了无缺血性中风病史个体中缺血性中风的发病率，并根据奥司他韦的使用情况进行分层。在调整年龄、性别和合并症后，使用奥司他韦与中风风险的显著差异无关（调整后HR = 1.02，95%CI：0.96 - 1.08；P = 0.511）。有缺血性中风病史的奥司他韦使用者（n = 2502）的死亡率与非使用者相比，累积死亡率较低（4.08%对6.45%）。多变量调整后，这种关联仍然显著，死亡率的调整后风险比为0.74（95%CI：0.61 - 0.89；P = 0.002）。在这个基于人群的无缺血性中风病史的大型队列中，在调整年龄、性别和合并症后，流感感染期间使用奥司他韦与中风发病率无关。值得注意的是，有缺血性中风病史的患者使用奥司他韦与全因死亡率降低有关，这表明存在潜在的生存益处，值得进一步研究。
