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Review raises questions about why government stockpiling zanamivir, oseltamivir
Tue, 31 Jan 2012 05:00:00 +0100 | Drug Topics - Top News
Zanamivir and oseltamivir (Tamiflu, Roche) can help prevent and treat the symptoms of influenza, but there is not enough information to evaluate the drugs’ safety and efficacy for preventing the spread of flu or pneumonia, according to a new review published online January 18. (Source: Drug Topics - Top News)

Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children.
Thu, 26 Jan 2012 08:18:08 +0100 | Cochrane Database of Systematic Reviews
CONCLUSIONS: We found a high risk of publication and reporting biases in the trial programme of oseltamivir. Sub-population analyses of the influenza infected population in the oseltamivir trial programme are not possible because the two arms are non-comparable due to oseltamivir's apparent interference with antibody production. The evidence supports a direct oseltamivir mechanism of action on symptoms but we are unable to draw conclusions about its effect on complications or transmission. We expect full clinical study reports containing study protocol, reporting analysis plan, statistical analysis plan and individual patient data to clarify outstanding issues. These full clinical study reports are at present unavailable to us. PMID: 22258996 [PubMed - in process] (Source: Cochrane Dat...

Amantadine and rimantadine for influenza A in children and the elderly.
Thu, 26 Jan 2012 08:18:08 +0100 | Cochrane Database of Systematic Reviews
CONCLUSIONS: AMT is effective in preventing influenza A in children but the NNTB is high (NNTB: 12 (95% CI 9 to 17). RMT probably helps the abatement of fever on day three of treatment, but the quality of the evidence is poor. Due to the small number of available studies, we could not reach a definitive conclusion on the safety of AMT or the effectiveness of RMT in preventing influenza in children and the elderly. PMID: 22258950 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Neuraminidase inhibitors for preventing and treating influenza in children.
Thu, 26 Jan 2012 08:18:08 +0100 | Cochrane Database of Systematic Reviews
CONCLUSIONS: Oseltamivir and zanamivir appear to have modest benefit in reducing duration of illness in children with influenza. However, our analysis was limited by small sample sizes and an inability to pool data from different studies. Oseltamivir reduces the incidence of acute otitis media in children aged one to five years but is associated with a significantly increased risk of vomiting. One study demonstrated that laninamivir octanoate was more effective than oseltamivir in shortening duration of illness in children with oseltamivir-resistant influenza A/H1N1. The benefit of oseltamivir and zanamivir in preventing the transmission of influenza in households is modest and based on weak evidence. However, the clinical efficacy of neuraminidase inhibitors in 'at risk' children is still...

NHS Choices publishes assessment of reports casting doubt over the efficacy of oseltamivir (Tamiflu®)
Mon, 23 Jan 2012 05:00:00 +0100 | NeLM - News
Source: NHS Choices, British Medical Journal Area: News The 'Behind the Headlines' service from NHS Choices has published a quality assessment of press reports that there have been doubts cast over the efficacy of oseltamivir (Tamiflu), as the manufacturer has been 'accused of secrecy over trial data' (reported by the Daily Telegraph and others, 18th January 2012).   The assessment notes that these reports follow the publication of a Cochrane systematic review, which sought to evaluate the effectiveness of the neuraminidase inhibitors oseltamivir (Tamiflu®) and zanamivir (Relenza®) in preventing and treating influenza in healthy adults and children.  The authors of the Cochrane review note that a previous review of this topic documented substantial risks of publication bia...

BMJ publishes articles discussing the Cochrane review on oseltamivir and its implications
Mon, 23 Jan 2012 05:00:00 +0100 | NeLM - News
Source: NHS Choices, British Medical Journal Area: News A Cochrane systematic review which sought to evaluate the effectiveness of the neuraminidase inhibitors oseltamivir (Tamiflu®) and zanamivir (Relenza®) in preventing and treating influenza in healthy adults and children has recently been published.  The authors found a high risk of publication and reporting biases in the oseltamivir trial programme and were unable to draw conclusions about its effect on complications or transmission, as they were unable to obtain the full set of clinical study reports or obtain verification of data from the manufacturer.      The BMJ has featured a news article reporting on the Cochrane review.  This notes that the Cochrane group reviewed over 16,000 pages of clini...

Doubts cast over whether anti-flu drug Tamiflu works
Wed, 18 Jan 2012 17:35:00 +0100 | NHS News Feed
Conclusion This systematic review aimed to assess comprehensively the effect of NIs including Tamiflu and Relenza on the prevention and treatment of flu in healthy adults and children by including results known to have been missed in previous reviews. In this sense, the review failed to meet its aims but for two distinct reasons. The evidence review of Relenza was suspended because new information about its effects on individual patients became available. The results of this are eagerly awaited. The review of Tamiflu was incomplete because of difficulties in obtaining sufficiently detailed information from the manufacturer. The systematic review included 25 studies in its final analysis, but had to exclude 42 relevant studies. By excluding these relevant studies, important information tha...

Influenza Virus Resistance to Neuraminidase Inhibitors: Implications for Treatment
Tue, 17 Jan 2012 07:14:02 +0100 | Current Infectious Disease Reports
Abstract  Oseltamivir and Zanamivir are the two main Neuraminidase inhibitors used for the treatment of Influenza. Oseltamivir resistance has been identified in non-pandemic influenza viruses, as well as H1N1 pandemic Influenza A viruses. Resistance is associated with increased morbidity, and poorer outcomes in severely immunocompromised hosts. Newer neuraminidase inhibitors, increased vaccination and combination therapy may be alternatives for the treatment of Influenza in this setting. Content Type Journal ArticleCategory Upper Respiratory, Head, and Neck Infections ( I. Brook, Section Editor)Pages 1-6DOI 10.1007/s11908-012-0236-xAuthors Shivanjali Shankaran, Hunter Holmes McGuire VA Medical Center, 1201 Broad rock Boulevard, Richmond, VA 23249, USAGonzalo M. L. Bearm...

Oseltamivir or zanamivir - Can mothers breastfeed after treatment for influenza?
Mon, 16 Jan 2012 05:00:00 +0100 | NeLM - Medicines Q and A
Source: Trent Medicines Information Service Area: Evidence > Medicines Q & A Oseltamivir and its active metabolite, oseltamivir carboxylate, are excreted into human breast milk in very small amounts.   Limited data suggest that clinical sequelae from maternal treatment would not be expected in a breastfed infant. There are no data on zanamivir use during lactation but based on limited bioavailability the systemic exposure of a breastfed infant from maternal treatment is expected to be insignificant. The overall consensus is that treatment with either drug is not a reason to discontinue, or put limitations on, breastfeeding full-term or pre-term infants.   Due to the very small amounts transferred into breast milk, and the limited oral bioavailability of eith...