Flu Drugs May Do More Harm Than Good, Researchers Find

[dixiegrrrrl]

Tamiflu and Relenza, antiviral drugs stockpiled by governments to tame influenza outbreaks, haven’t been proven to prevent pandemics and may cause more harm in some patients than good, researchers said after reviewing 170,000 pages of clinical-trial data.

The findings, published today in the journal BMJ, came from the Cochrane Collaboration, a nonprofit U.K. research organization, using information obtained from Roche Holding AG (ROG), maker of Tamiflu, and GlaxoSmithKline Plc (GSK), which sells Relenza.

The U.S. has spent $1.3 billion, and the U.K. 424 million pounds ($710 million), stockpiling the drugs following a 2009 outbreak of the H1N1 swine flu. The Cochrane researchers, who examined the reports of 20 Tamiflu trials and 26 Relenza studies, found Tamiflu reduced flu symptoms for adults by 17 hours without curbing the number of hospitalizations. Tamiflu also caused vomiting, delirium and loss of kidney function in some patients. There was no evidence that using the treatments could stop a massive outbreak, the researchers said.

“There’s no credible way these drugs could prevent a pandemic,” Carl Heneghan, one of the authors of today’s study and a professor of evidence-based medicine at the University of Oxford, said at a media briefing in London. Money spent on stockpiling “has been thrown down the drain.”

http://www.bloomberg.com/news/2014-04-09/flu-drugs-may-do-more-harm-than-good-researchers-find.html

“Drug companies have an irreducible conflict of interest,” Godlee said. “It’s not in their interest to create a clear picture of a drug.”

[libodem]

1. They are not kidding about the delirium

You wouldn't think something that isn't an actual psychoactive substance could be so mind altering. People say it really makes them feel weird.

[Journeyman]

2. Wasn't money "thrown down a drain." It was deposited in the coffers of Roche & GlaxoSmithKline. . .

Don't ever let the bastards off by deflecting the losses and the blame. Only by holding them accountable for their part in the crimes against us can we ever hope to correct the injustices.

[Glassunion]

3. Woo

Sorry, couldn't resist.

[Mojorabbit]

5. I don't know

I follow the odd flues that pop up all over the world. Consistently people who received tamiflu had better survival odds for H5N1 if the news reports are accurate that I have read over the years. I have not been following the H7N9 outbreaks the past few years close enough to see it this holds true.

[jtuck004]

8. "if the news reports are accurate" and almost certainly influenced by people with a financial

stake in reporting this outcome. Which could well be why the report above is interesting.

[Mojorabbit]

12. I don't think so in this case

In the hospitals in Indonesia where the virus was recognized, those that received tamiflu mostly lived though it took sometimes months of treatment and those who did not get it in a timely manner croaked. I follow the news there and the international infectious disease doc listserve promed. For your garden variety flu though, I agree the risk of untoward effects outweighs the benefits. With a novel flu with a high fatality rate, I think it is worth the risk. Just my opinion.

[jtuck004]

15. According to the data above, most make it anyway. The difference in Indonesia appears to

also be their reliance on traditional medicine and the delay it causes in seeking hospital care. If they go to the hospital early, whether they get Tamifu or not, their odds are remarkably better because the symptoms can be treated, much like we do with any flu or viral disease.

From the large amount of data above (and a little outside reading) it appears the difference between those who took it and those who didn't is a lessening, in some cases about a day less showing symptoms, but some with worse problems than they started with from a drug which the world stockpiles, which then has to be thrown away and repurchased every year, on a global scale. Still just as many people die. The difference seems to be if they get to a hospital for iv therapy of fluids and chemical balance. I know people want to believe it's a cure (especially in this culture) but the evidence indicates the research, performed by people with a vested stake in the outcome, differs from the results in the outer world. That's a bad thing, and those profits could be used to accomplish more.

I was just reading that they had a die-off of hundreds of thousands of birds in Indonesia. Maybe they should give it to the poultry

[Mojorabbit]

16. Here is an article from a while back where they looked into it

http://jid.oxfordjournals.org/content/202/8/1149.full
However, early experience with oseltamivir treatment did not suggest a substantial benefit, and a concern for resistance development emerged [4, 11, 12]. This initially discouraging circumstance was thought possibly to be attributable to late onset of treatment and altered pharmacokinetics because of illness severity and gastrointestinal symptoms. However, subsequent experience in larger numbers of patients suggested oseltamivir treatment could reduce the risk of death; earlier treatment conveyed enhanced patient survival in Indonesia, and treatment enhanced survival in Vietnamese patients [14, 15]. Additionally, an H5N1 update from WHO pooled the results of oseltamivir treatment from various countries and proposed an overall reduction in death of 74%, and a surprising reduction of 95% in countries with clade 2 infections [6].

[jtuck004]

17. Yes, and even in the same article they call the research into question. There's little doubt

that it gains you half a day, which, as they said above "shows some benefit" from the drug, but the suggestion appears to be that it does more, and that is what is in question.

Here is another one questioning how results are derived for drug use -

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001201

Regardless, I'm pretty skeptical about the claims of any corporation these days.

Certainly worth seeing if the research that has been hidden can be repeated. That would be basic science anyway.

[dreamnightwind]

6. Tamiflu, Rumsfeld and Cheney

I wasn't sure which source to use...

http://www.dailykos.com/story/2009/04/27/725102/-Tamiflu-Rumsfeld-and-Cheney

The real point of interest is the company in California who developed Tamiflu, Gilead Sciences, listed on the NASDAQ as (GILD). US Secretary of Defense, Donald H. Rumsfeld, was Chairman of the Board of Gilead Sciences from 1997 until early 2001 when he became Defense Secretary.

A as-yet-unconfirmed report is that Rumsfeld recently purchased additional stock in his former company, Gilead Sciences, worth $18 million, making him one of its largest if not the largest stock owners today. Whether that is true or not, when the Bird Flu scare was just heating up, according to a report in a November 2005 issue of Fortune magazine, the Defense Secretary decided not to sell his many shares in Gilead so as to ‘avoid being accused of insider trading.’ If true, that meant Mr. Rumsfeld, apparently not one to shy away from turning a fast buck, had bagged an eye-popping windfall, as demand for Tamiflu worldwide exploded. On October of the same year the Pentagon announced it had stockpiled quantities of Tamiflu for members of the military.

Since early 2001 when Rumsfeld left the board of Gilead Sciences to become Defense Secretary, Gilead’s stock price has gone from around $7 per share to just a hair above $50 a share in 2005. The future price direction? The stratosphere, especially since the President made it an explicit goal of the US ‘flu defense pre-emptive war’ on November 1, 2005.
Gilead, which signed over the world marketing rights to Hoffmann-LaRoche, gets 10% of every dose of Tamiflu sold. Gilead was presently in a legal battle to retake 100% marketing control as well.

FYI, while the marketing of Tamiflu to prevent a pandemic probably makes no sense other than to make certain people extremely rich, I have taken Tamiflu and it was my impression that it helped. I am in a high-risk asthma group for influenza complications, so it's a much bigger deal when I get respiratory infections. I took Tamiflu soon after getting the real flu symptoms (no doubt in this case, hit hard), and recovered much better than I usually do from these things. I did think it made me feel strange, hard to tease that out though because having the flu is strange itself. Strictly anecdotal, but for high-risk patients I still might recommend it.

[Lobo27]

7. In the past I've read things that with medicine...

We are weakening our immune system so badly that some people in the scientific/medicinal fields. Feel that the common cold could eventually wipe us out.

[lindysalsagal]

9. Tamiflu works. It's a miracle drug. If you have the real flu.

Lots of people claim to have the flu but don’t. If you do, every nerve in your body aches all at once, and you'll gladly trade in a little clarity for any relief. You're still laid out flat for a week: But on tamiflu, you’re not half as miserable .

I'll take it again if I ever need it.

[tosh]

13. I agree 100%.

I had the need for it this winter for the first time ever. I was AMAZED at how well it worked.

Your description is spot-on.

[L0oniX]

14. Can cause liver damage if abused.

[nessa]

18. Yep. My son had a positive flu test. ...

He ached all over, had a fever of 103, was short of breath and had an asthma flair. The pulsox reading was around 90. He took tamiflu, took a nap and said he felt like a new man. Fever was gone, and aches were gone. He still felt weak and still had some chest congestion, but he said it really did feel like a miracle drug.

[X_Digger]

10. God I hate science reporting.

That's not what the Cochrane review actually says (the headline.)

In some patients who are immunocompromised, have renal or liver issues, the drugs can have adverse side effects- side effects that are manageable.

If you're not in one of those subsets of patients? There's a statistically significant reduction in severity, duration, and fatalities from taking the drugs.

[laundry_queen]

11. Yep I noticed that.

Tamiflu still works to reduce the severity and duration of symptoms. That is not disputed even by the article. So it's hyperbole to assert that governments have wasted tons of money stockpiling it. In the event of an outbreak, it's still a useful tool.