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Government spending on Tamfilu is justified

Published on 30/01/15 at 02:54pm
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The most thorough analysis of Roche’s Tamiflu to date suggests that the controversial treatment can shorten the duration of flu symptoms by about a day – but concerns over side effects remain.

Previously the government’s decision to stockpile £424 million of the drug had been called a waste of money, after research published in the BMJ suggested there was no evidence for its effectiveness.

The new meta-analysis, conducted by an independent group and published in The Lancet, included all available published and unpublished trials in patients with laboratory-confirmed influenza – totaling nine trials in 4,328 patients between 1997 and 2001.

It found that Tamiflu (oseltamivir) reduced the duration of influenza symptoms by 21% compared to placebo – from 123 hours to 98 hours. It also indicated that the drug decreases the risk of respiratory tract infections requiring antibiotics by 44% and hospital admission for any cause by 63 per cent.

“The safety and effectiveness of oseltamivir has been hotly debated, with some researchers claiming there is little evidence that oseltamivir works,” says Professor Arnold Monto from the University of Michigan, who led the study along with Professor Stuart Pocock from the London school of hygiene and tropical medicine.

“Our meta-analysis provides compelling evidence that oseltamivir therapy reduces by one day the typical length of illness in adults infected with influenza and also prevents complications and reduces the number of people needing hospital treatment.”

However, the analysis also confirmed that using Tamiflu significantly increased the risk of nausea and vomiting, by 3.7% and 4.7% respectively – and Monto warns that people shouldn’t yet jump to conclusions about whether it is actually beneficial.

“Whether the magnitude of these benefits outweigh the harms of nausea and vomiting needs careful consideration,” he says.

The data was made available by Roche and the study was funded by the Multiparty Group for Advice on Science (MUGAS) foundation.

In a joint comment appended to the research, Heath Kelly from the Australian National University in Canberra and Benjamin Cowling from the University of Hong Kong say that because the side effects can affect all patients even if they don’t have influenza: “rapid diagnostic testing, if available, is advisable before oseltamivir administration in routine clinical practice”.

They add that Tamiflu could be used ‘presumptively’ in a pandemic when the outcome of infection is likely to be severe.

George Underwood

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