Does Tamiflu actually work (and is it safe)?

Most of us will be familiar with the H1N1 (‘swine flu’) pandemic that never was. At the height of the hysteria here in the UK, individuals could phone up a help-line, answer a few questions, and get sent the drug Tamiflu (oseltamivir). According to a news report here, it turns out that only about 20 per cent of the people who were dispensed Tamiflu (over the phone) for H1N1 infection actually had H1N1 infection. Apparently, about 800,000 packets of Tamiflu (at about £15 a pop) were dispensed erroneously.

But the real story is not so much about this, I think, but the fact that it also turns out there really is no very good evidence that Tamiflu does much good. A review of the relevant evidence has this week been published in the British Medical Journal [1]. The authors of this study belong to an esteemed and generally trusted collection of researchers referred to as the ‘Cochrane Collaboration’.

One of the findings of this study is that Tamiflu does reduce the duration of influenza symptoms, by about a day. The authors describe this as a “modest benefit”. I’m inclined to agree with them.

Another outcome assessed by this review related to the complications of flu. Flu is generally harmless, but it becomes less harmless should it lead to complications such as chest infections (lower respiratory tract infection). Now, previously there had been a meta-analysis (a conglomeration of relevant studies) that appeared to show benefit on this account. This was included in a previous review (2005) by the same authors. Now, though, the authors have decided to discount it. That’s because of the 10 studies that made up the meta-analysis, only two were actually published. According to the review authors:  “the remainder were offered to us under conditions we thought unacceptable, and what was offered to us was insufficient to analyse properly”. One wonders why the original meta-analysis was included in the previous review, seeing as it was of such dubious quality. But, I suppose even researchers from the esteemed Cochrane Collaboration can make mistakes.

The authors also comment that: “The remaining data showed no benefit for oseltamivir against complications.” In other words, there really is no good evidence that Tamiflu reduces the risk of complications.

And that’s not all, with regard to their assessment of the potential harms, the authors comment: “We therefore found under-reported evidence of varied quality, which could not answer concerns about the toxicity of neuraminidase inhibitors, especially oseltamivir. Governments should set up studies to monitor the safety of neuraminidase inhibitors.”

So, in summary, what we have in Tamiflu is a drug of modest benefit and, largely, unknown safety. And this drug was apparently dished out to a million people, the vast majority of whom didn’t even have the infection Tamiflu was supposed to be treating. Excuse me if I don’t regard this as a shining example of ‘evidence-based medicine’. But, we all know we can trust out Governments to give us the best advice and healthcare, right?

References:

1. Jefferson T, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults: systematic review and meta-analysis. BMJ 2009;339:b5106

3 Responses to Does Tamiflu actually work (and is it safe)?

  1. Joseph 11 December 2009 at 11:11 pm #

    Governments as well as rich benefactors needed to finance independent trials such as some vaccines and topics like cytokine storm. The paradox of young people with good immune system status are succumbing to both the swine flu virus and also to swine flu vaccine (strenuously denied and arrogantly dismissed). When the unfortunate death occur in the non-vaccinated is a possible indication for the virus effect whereas when the inoculated dies but also infected we can not tell. When the vaccinated dies without being infected it is most likely the vaccine and/or some components responsible for the cytokine storm. Research needed to find solution to dampen the overreacting immune system so as to save the lives especially the younger whose excellent immune readiness to start with gives a deadly head-start to the response.

    Be well! joseph

  2. Jamie 14 December 2009 at 9:53 pm #

    The rapid response letters to this report in the BMJ make for fascinating reading. Yet another example of big pharma pulling the wool over our eyes. Would hate to think how much money New Zealand has wasted on this rubbish.

    http://www.bmj.com/cgi/eletters/339/dec07_2/b5106

  3. Joe 24 May 2011 at 7:06 am #

    Watch this video!!!

    Glaxo Smith Klein and Roche making billions with backing of government sponsored fear mongering. Injecting children and adults with ineffective and neurotoxic agents in the name of profit.

    Thanking my lucky stars that I had enough sense to refuse shots on my baby girl. These corperate pigs are lying to you.

    http://www.cbc.ca/video/#/News/Health/­­­­1244503490/ID=1945205880

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