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[Sheb]

What's a vayaya?

[Dutchling]

Somehow vajayjay got correced to vayaya.

[palsch]

A fairly detailed look at the Tamiflu analysis just published.

I'd recommend reading the whole thing to put it in context. It's been known for a while that, based on published trials, Tamiflu has a (small but real) impact on the duration of flu but that there was no published satisfying evidence for it's impact on infection rates or reduction of serious complications and hospitalisation. It seems that different (or at least marginal) evidence was shown to different groups (and we are talking different regulators coming to different conclusions on its effectiveness) while being kept out of the hands of academics who wanted to conduct meta-analysis.

[Sheb]

I'm hardly surprised. Pharma executives are some of the few people for which I'd like to reinstate the death penalty.

[ChairmanPoo]

IMO it's a pretty lousy drug overall. You have a pretty narrow window for administration (48h after symptom onset, IIRC) in order for the treatment to be effective.

Also, if anyone's curious, immunocompromised patients can have positive CPRs for airway viruses for months or years (and supposedly can be actively contagious, although not necessarily symptomatic), and tamiflu does jackshit for that. You can keep it on for weeks and the cpr will remain positive no matter what. 


 

[Sheb]

Well, it does its job: you get over the flu slightly faster.

[palsch]

Well, it does its job: you get over the flu slightly faster.

Except that isn't the reason the British government stockpiled half a billion pounds worth of the stuff. The goal was to reduce death rates during a pandemic. That would require either a reduction in transmission rates, a reduction in serious complications (including deaths) or both. It seems it was promoted as both when the evidence doesn't show either.

And, looking at the reivew itself it seems to do what it does in much the same way as, say, paracetamol. Which is to say it doesn't touch the virus itself. And paracetamol has far fewer side effects. To quote the abstract;

Mechanism of action for beneficial effects

These findings all suggest that the low immune response with low levels of pro-inflammatory cytokines, which is induced by the action of oseltamivir carboxylate, may reduce the symptoms of influenza unrelated to an inhibition of influenza virus replication. The potential hypothermic or antipyretic effect of oseltamivir as a central nervous system depressant may also contribute to the apparent reduction of host symptoms. Statements made on the capacity of oseltamivir to interrupt viral transmission and reduce complications are not supported by any data we have been able to access.

The mechanism of action proposed by the producers (influenza virus-specific) does not fit the clinical evidence which suggests a multi-system and central action.

It's a nice drug to have on the market, but that isn't really the point anymore. The way it was sold and stockpiled was flat out wrong, and that's heavily due to the limited release of trial information.

[Sheb]

Oh, I know all that. I was answering to ChairmanPoo.

But yeah, something is rotten in the state of BigPharma. The very fact that Drug companies can choose which studies to publish or submit to regulators is so wrong I want to have their heads on spikes. It's not only loss of money, it's also losses of lives when people get prescribed less than optimal treatment because those fuckers hide or corrupt the date.

[Descan]

I'm pretty sure it's because the people making the laws know Jack and shit about how science -actually works-, and Jack left town.

To them, the idea that a study that shows positive results is the only one worth looking at seems on the level. Of course, it isn't, but to someone who doesn't know how the process works, it'd make sense.

And then you add corruption to it all, and it's just a mess...

[Mr. Strange]

Reading this thing just made me feel sick...

But I'm sure they'll have drug ready for that soon.

[Knit tie]

I have plenty of anecdotal evidence that oceltamivir carboxylate does nothing to prevent the spread of the influenza virus. We once had a bunch of guys with a flu admitted into a hospital where my friend works and prescribed Tamiflu, which was thought of as a miracle drug at the time, and nothing else. They managed to get an entire wing of patients and half the doctors and nurses infected with that particular stamm of influenza. Suffice to say, the hospital hasn't bought a single Tamiflu pill since.

[MetalSlimeHunt]

That isn't empirical evidence, that's anecdotal evidence.

[Knit tie]

Thanks for telling me, learned the term "anecdotal" and fixed my post. My point still stands, Big Pharma companies have downright deceptive marketing that can lead to serious harm in the right circumstances.

[Putnam]

My point still stands

Anecdotal evidence is completely and utterly worthless to any discussion even tangentially attached to the word "science" or any debate on fact whatsoever, so not really.

[Knit tie]

A fairly detailed look at the Tamiflu analysis just published.

I was referring to this.

Speaking of flu drugs, does anybody know what the scientific community think about a medicine called Relenza? Its marketed in Russia as an anti-influenza wonder cure, along with Tamiflu