This week's BMJ contains an updated Cochrane Review on neuraminidase inhibitors for treating and preventing influenza. The journal issue also contains several other related articles, primarily focusing on the controversial aspects behind the review. The previous Cochrane Review used a meta-analysis that relied heavily on unpublished data. For the update, the Cochrane reviewers tried to obtain the primary data from Roche, but were unable to do so, and the study in question was eliminated from the new review. The review concludes that the drugs are modestly effective in the treatment of influenza and not effective at preventing influenza-like illness since only a small fraction of ILI cases are caused by influenza. In a separate publication in the same issue, Peter Doshi, one of the authors of the Cochrane review, states: "We are no longer sure that oseltamivir offers a therapeutic and public health policy advantage over cheap, over the counter drugs such as aspirin."  

So, how much money has been spent on a drug of questionable effectiveness?


  1. Perhaps Peter Doshi should have selected another medication besides aspirin given its association with Reye's syndrome in children. For those under 19, aspirin should not be given during a febrile illness.

  2. ...or the hypothesis that high-dose aspirin may have contributed to 1918 H1N1 mortality as proposed by KM Starko in CID.

    Overall though, given the efficacy data on Tamiflu has always been unimpressive the hysteria around Tamiflu resistance seems off the mark.


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