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Benefits of flu drugs questioned

A review of studies assessing the use of Roche's Tamiflu and GSK's Relenza has cast doubt on the policy of giving antiviral drugs to children

A review of studies assessing the use of Rochess Tamiflu (oseltamivir) and GlaxoSmithKline's (GSK) Relenza (zanamivir) has cast doubt on the policy of giving antiviral drugs to children as a treatment for, or prevention against, seasonal influenza.

A review in the British Medical Journal (BMJ) shows Tamiflu and Relenza rarely prevent complications in children, yet carry side-effects. Although the study was not specific to the current swine flu pandemic, the authors say these drugs are unlikely to help children who catch the H1N1 virus.

The government, however, has stuck by its policy of offering them to anyone infected with swine flu saying a 'safety-first approach' remained a sensible and responsible way forward, but promised to keep the policy under review.

The researchers (from the University of Oxford) conducted a review of four trials involving 1,766 children aged 12 years and under who were treated for seasonal influenza with either Tamiflu or Relenza, and three studies of 863 children in the same age group who were given the anti-virals as a preventative measure.

The data showed that the antivirals shortened the average duration of illness by up to 1.5 days, and also reduced transmission by 8 per cent when used as a post-exposure prevention. But treatment was not associated with a decreased likelihood of children requiring antibiotics. Also it was found that Tamiflu did not reduce asthma exacerbations and that Roche's drug was linked to an increased risk of vomiting.

Researcher Dr Carl Heneghan, a GP and clinical lecturer at Oxford University, said the current policy of giving Tamiflu for mild illness was an "inappropriate strategy". He said: "The downside of the harms outweigh the one-day reduction in symptomatic benefits."

Flu expert, Professor Hugh Pennington said the findings were not surprising and underlined what was already known about Tamiflu: "[It] has a place but it's not a wonder cure."

These findings follow the release of results from two recent studies conducted by the UK's Health Protection Agency, which found that more than half of surveyed children given Tamiflu to prevent H1N1 infection reported a side-effect.

There were an estimated 30,000 new cases of swine flu in England in the last week, a drop compared to 110,000 cases the week before. A decreased incidence has also been seen in Scotland and Wales in the past week. The total swine-flu related deaths in England and Scotland stands at 41.

Antivirals are the mainstay of treatment at the moment until a vaccine becomes available, which is expected in September.

11th August 2009

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