The last and perhaps the latest salvo in a long-standing debate on the merits of the drug of flu fight against Tamiflu was fired off today, but it seems unlikely to appease skeptics or feed unanimity around the effects of the drug.
For years, members of The Cochrane Collaboration, an international network of scientists who review medical evidence, have charged that Tamiflu's benefits are exaggerated. They agree that if taken soon after symptoms surface, the drug reduced by approximately one day someone's life feels sick. But they deny that the evidence, including 12 randomized trials conducted by Roche, which makes Tamiflu, known generically as oseltamivir shows that this reduces serious complications, hospitalizations and deaths. The Cochrane group also focused on transparency in science: He argued that publication bias had left Tamiflu look better than it really was
The dispute prompted Roche and certain flu. Researchers undertake to re-analyze the data and that is what is published online today. Writing in The Lancet , four influenza experts describe the mix of data from nine clinical trials of over 4,000 patients to assess Tamiflu. Pooling the data, it is easier to discern the effect of the drug on rare outcomes, such as pneumonia. And, the authors report, Tamiflu made a significant difference, which reduces the risk of hospitalization by 63%. The actual numbers are small: Nine of the 1591 participants who took Tamiflu were admitted to hospital, and 22 of 1302 those not taking the drug ended up there. The drug was also associated with fewer cases of infections of the lower respiratory tract that called for antibiotics, the authors say, such as bronchitis or bacterial pneumonia. Patients on the drug had a risk of 4.9% compared to a risk of 8.7% if not on medication. "Significant risk reductions have been detected," the authors note, acknowledging that Tamiflu has also had side effects including nausea and vomiting, which must be balanced against its benefits.
The Lancet paper may be unlikely to compel many people to switch sides, however. "There is no new data presented here on complications or hospitalizations that we do not already know of," said Peter Doshi epidemiologist at the University of Maryland School of Pharmacy in Baltimore, a critical part of Roche and Cochrane group that reviewed the Tamiflu studies differences, he says, stem from how complications are interpreted. for example, all cases were recorded as pneumonia really pneumonia clinical study reports,? reviewed by Cochrane reviewers like Doshi, suggest that they are not always believed it.
More troubling, Doshi said, is that the new analysis was funded by Roche through a foundation called that Mugas it helps support. This detail was not shared in the Lancet press release, that of 'Doshi says is "disappointing" -Although it does not appear at the end of the document. "This not want independent science, "says Doshi.
Others suggest that the new report does not change much about our understanding of Tamiflu, but they rent Roche to support and agree with his conclusion that the drug reduced hospitalizations. "The important thing about this study is that it shows that Roche [was] does not hide the skeletons in his closet," said Peter Openshaw, director of the Centre for respiratory infection at Imperial College London, in a prepared statement. "Oseltamivir is not a perfect drug, but it does what you might expect," especially when administered after influenza took the hand and is more difficult to fight back.
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