Researchers affiliated with the Cochrane Collaboration report that, while Tamiflu shortens symptoms of influenza by half a day, there is no good evidence to support claims that it reduces admissions to the hospital or complications of influenza.
The latest updated Cochrane Review, “Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children,” is based on full internal reports of 20 Tamiflu and 26 Relenza trials, which involved more than 24,000 people. The findings challenge the historical assumption that neuraminidase inhibitors are effective in combating influenza. The evidence also suggests there are insufficient grounds to support the use of Tamiflu in preventing person-to-person spread of influenza.
This raises further questions about the most effective way to support drug regulation and public health policy decision making, say Cochrane officials, who add that claims about the effectiveness of Tamiflu against complications were a key factor in decisions made by governments around the world to stockpile these drugs in case of a pandemic. The U.S. has spent more than $1.3 billion buying a strategic reserve of antivirals, while in the U.K. the government has spent almost £424 million ($711 million) for a stockpile of about 40 million doses, cites the Cochrane study.
“We now have the most robust, comprehensive review on neuraminidase inhibitors that exists,” said David Tovey, M.D., editor-in-chief, Cochrane. “Initially thought to reduce hospitalizations and serious complications from influenza, the review highlights that Tamiflu is not proven to do this, and it also seems to lead to harmful effects that were not fully reported in the original publications. This shows the importance of ensuring that trial data are transparent and accessible.”
Officials at Roche immediately responded to the Cochrane report.
“We disagree with the overall conclusions of this report. Roche stands behind the wealth of data for Tamiflu and the decisions of public health agencies worldwide, including the U.S. and European Centres for Disease Control & Prevention and the World Health Organization,” according to Roche’s U.K. Medical Director, Daniel Thurley, M.D. “The report’s methodology is often unclear and inappropriate, and their conclusions could potentially have serious public health implications. Neuraminidase inhibitors are a vital treatment option for patients with influenza.”
Cochrane is a not-for-profit global independent network of health practitioners, researchers, patient advocates, and others who study clinical trial and other healthcare data to assist decision makers engaged in determining the most effective drug therapies against human diseases.