Tamiflu's Effectiveness Doubted
Expert Analysis Concludes Antiviral Drug May Not Prevent Complications in Healthy People
Tamiflu Effective? Review Details continued...
"This benefit has been generalized to assume benefit for very ill people in hospital," the authors write. Although this seems reasonable, they say they have no data to support this.
The data on the effectiveness of Tamiflu against complications of the flu are "confusing," the researchers write. The researchers had to drop eight trials that were never fully published, although they were included in the previous review. But the researchers dropped them for this review because they could not verify the results independently.
Del Mar's bottom-line advice for healthy people? "Don't take [the antivirals] to prevent complications because we don’t have enough good data for that. It reduces the [duration of the] illness by one day. So you have to make a decision about whether it’s worth it or not."
A viable alternative, he tells WebMD, may be to take acetaminophen or "lemon sips" -- a hot lemon drink.
Roche responded by saying the company believes in the "robustness and integrity" of the data, claiming that if the Cochrane researchers had simply signed a confidentiality agreement to protect the anonymity of clinical trial patients, they could have had the data.
In a letter to BMJ, Roche officials say they responded fully to all questions asked by BMJ and the news channel. The pharmaceutical giant has now posted study summaries online and will provide full reports on a password-protected site.
Most of the information presented in the new review is known by physicians, says William Schaffner, MD, an infectious disease specialist and chairman of the department of preventive medicine at Vanderbilt University Medical Center in Nashville. "What’s new is bringing it all together."
Costs seem to be a major concern of the researchers, he says. "The editorialists are concerned that governments have purchased large stockpiles," he says. Their concerns focus on the fact that the money could have been better used elsewhere.
"We are not treating every patient who comes into our ER with Tamiflu," Schaffner says. Those with underlying conditions such as heart disease do get the drug, he says, as well as healthy people if something like trouble breathing develops.
Another doctor in practice, Peter Galier, MD, former chief of staff at Santa Monica-UCLA & Orthopaedic Hospital, says he is not seeing overuse of the drugs. Lessening the duration of flu for healthy people may be optional, he says, but if you use the drugs to lessen the severity of the disease in those who are immune compromised, asthmatic, or have lung disease or other problems, "you are doing a service."