Tamiflu analysis slammed by Cochrane


By Nicola Garrett

3 Feb 2015

An analysis published in the Lancet that concluded the flu drug Tamiflu (osteltamivir) is effective after all has been slammed by a Cochrane reviewer.

The review which looked at 9 studies found the drug reduced flu symptoms by about a day, compared to placebo. It reduced the risk of lower respiratory tract infections requiring antibiotics by 44% compared with placebo (4.9% vs 8.7%), and hospital admission for any cause by 63% (0.6% vs 1.7%) in adults with laboratory-confirmed influenza.

Lead author Arnold Monto, Professor of Epidemiology at the University of Michigan School of Public Health, said the 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 he noted that whether the magnitude of these benefits outweigh the harms of nausea and vomiting needs “careful consideration.”

The findings are in contrast to a BMJ review published last year that found the drug, manufactured by Roche, failed to reduce the spread of flu or flu complications or reduce hospitalisations.

However in a blog on the Centre for Evidence Based Medicine website Tom Jefferson, a Cochrane researcher and co-author of  the BMJ review questioned the methodology of the Lancet analysis as well as its integrity.

For instance the outcome “pneumonia”  was not backed up by chest-x-ray, he noted.

“The use of antibiotics as a proxy for severity also shows that the authors have never sat in a GP’s surgery, where influenza-like illness presents. Antibiotic prescriptions are not necessarily synonymous for severity, as widespread bacterial resistance shows,” he wrote.

The study is backed by Roche through a consortium called MUGAS affiliated with the Belgium based communications company Semiotics which promotes “social marketing”, he added.

The Lancet paper states Roche did not have a role in analyzing or preparing the paper.

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