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Tamiflu’s Widespread Use, Effectiveness Is Questioned

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3 Star

Tamiflu’s Widespread Use, Effectiveness Is Questioned

Our Review Summary

This story discusses findings of a meta-analysis, or review of many studies, of anti-viral medications conducted by European researchers and published in the Lancet. According to this review of 51 randomized controlled trials, antiviral drugs such as Tamiflu are only effective in reducing symptoms of influenza type A and B by about 50%, and not as effective in the cases of “flu-like” illnesses. Doctors can and should test patients to determine if they have influenza type A and B viruses before prescribing anti-viral medications such as Tamiflu; the drugs should not be taken for flu-like symptoms and non-life threatening influenza. In fact, Tamiflu is ineffective for other types of flu-like illnesses. The main disadvantage of the misuse of anti-viral medications is the risk of developing a resistance to these drugs, which is mentioned in this article. However, there is no mention of side effects of anti-viral drugs, which can include gastrointestinal problems, nausea, insomnia and hallucinations. The risk ofthese side effects is greater in older people. No quantitative data is provided on either side effects or benefits on any of the anti-viral medications. The message perhaps not conveyed strongly enough by this piece is that there is no need to stockpile Tamiflu. Considering that WHO, CDC and other health organizations continue to recommend stockpiling Tamiflu, the cost of this practice would be interesting to note. No information on the cost of anti-viral drugs is provided. There was also little discussion to counter the statement: “Roche and the WHO agreed there aren’t yet large human studies showing that Tamiflu is effective against bird flu. But they said animal studies and anecdotal evidence in humans show the drug is active against the H5N1 avian-flu virus.” There is no credible evidence at this time that Tamiflu is effective against avian flu. Anecdotal evidence and animal studies are insufficient, and further controlled clinical trials on humans are needed to determine if these anti-virals aree effective, safe and appropriate for a large population. Tamiflu reduces the symptoms of the flu by only 1-1.5 days and it may not prevent transmission of the virus. While the drug may be appropriate as flu prevention in a household, it would not likely be very effective during a flu epidemic.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

No information on the

cost of anti-viral drugs for treating non A or B strain viruses. No information on global cost for preventative use.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

No quantitative estimates of benefits provided in this news story, though they are available in

the journal article upon which the story is based.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

No mention of the incidence or severity of side effects of the anti-viral drugs,

which include gastrointestinal problems, nausea, insomnia and hallucinations. More prevalent in older patients.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This was a meta-analysis of 50

clinical trials examining treatment efficacy, prophylactic use and side effects of several anti-viral flu drugs. This needs

to be clearer: it was a study of studies. There was little discussion of the findings to counter the statement: “Roche and

the WHO agreed there aren’t yet large human studies showing that Tamiflu is effective against bird flu. But they said animal

studies and anecdotal evidence in humans show the drug is active against the H5N1 avian-flu virus.” There is no credible

evidence that Tamiflu is effective against avian flu. Anecdotal evidence and animal studies are insufficient and further

controlled clinical trials on humans are needed to determine if these anti-virals are effective, safe and appropriate for a

large population.

Does the story commit disease-mongering?

Satisfactory

Addresses

over-prescription of antiviral drugs in most cases of flu-like symptoms.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

Story says the

study was funded by U.K and Italian health depts. in conjunction with Cochrane Collaboration, an independent, non-profit

group.

Does the story compare the new approach with existing alternatives?

Satisfactory

Mentions disadvantages of

over-prescribing Tamiflu and Relenza when it not indicated, for example, in the case of flu-like symptoms and non-life

threatening influenza. The main disadvantage is developing a resistance to the antiviral drugs.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

This product is FDA

approved to treat Type A and B influenza, but no mention of FDA approval in story. This is relevant to the story if talk of

off-label treatment is being evaluated (i.e. other flu strains and avian flu).

Does the story establish the true novelty of the approach?

Satisfactory

Mentions that this treatment

is not as effective as previously thought at reducing symptoms or for controlling transmission of influenza.

Total Score: 4 of 9 Satisfactory

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