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Z medycznej prasy /british journal of medicine

Although billions have been spent on oseltamivir in the face of pandemic influenza, the team updating the Cochrane review of neuraminidase inhibitors in healthy adults found that the public evidence base for this global public health drug was fragmented and inconsistent. Peter Doshi tells the story

 Since August 2009, our Cochrane review team has tried to obtain the data needed to verify claims that oseltamivir (Tamiflu) lowers serious complications of influenza such as pneumonia. We failed, but in failing discovered that the public evidence base for this global public health drug is fragmented, inconsistent, and contradictory. We are no longer sure that oseltamivir offers a therapeutic and public health policy advantage over cheap, over the counter drugs such as aspirin. If the public is to trust in public health policies, the scientific basis informing knowledge of the harms and effects of those interventions must be public and open to independent analysis.

British researchers at the Cochrane Review, an international non-profit that reviews health information, looked at 20 previously published trials on the antiviral Tamiflu, or oseltamivir, for the prevention and treatment of seasonal flu. There was insufficient data to show whether the antiviral reduces complications such as pneumonia in healthy adults, they concluded. The reviewers also confirmed that Tamiflu shortens flu symptoms by about one day.

The study appears in Tuesday's online issue of the British Medical Journal. "Oseltamivir may reduce the risk of pneumonia in otherwise healthy people who contract flu. However, the absolute benefit is small, and side-effects and safety should also be considered," Prof. Nick Freemantle and Dr. Melanie Calvert from the University of Birmingham concluded.

British Medical Journal editor-in-chief Fiona Godlee warned that the review left unresolved important questions about effectiveness of the drugs.

"Governments around the world have spent billions of pounds on a drug that the scientific community now finds itself unable to judge," she said.

Roche has estimated sales of 1.6 billion pounds this year alone from the drug, the statement said.

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