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combating bird flu
Deaths and drug resistance cast doubt over use of Tamiflu
Andrew Jack from London
12/26/2005
Fresh doubts were cast lately on the efficacy of Tamiflu as a treatment for bird flu when one of the world's most prestigious medical journals published new reports of resistance to the drug and deaths in patients in Vietnam.
Menno de Jong and colleagues from the hospital for tropical diseases in Ho Chi Minh City recorded in the New England Journal of Medicine that four out of eight patients suffering from the H5N1 flu strain and treated with Tamiflu had died, including two who developed resistance.
The reports increase suggested levels of resistance to nearly 10 per cent, or three out of the 31 known human cases of H5N1 treated with Tamiflu, which is marketed by Roche of Switzerland.
The study raises new questions about the drug, which more than 50 governments have ordered in significant quantities in recent months as a potential prophylactic and treatment in the case of a flu pandemic.
An accompanying article in the Journal reinforced calls for alternative approaches to treatment for a pandemic, including the stockpiling of the rival drug zanamivir, or Relenza.
Dr Anne Moscona wrote that individuals' stockpiling of Tamiflu was "potentially dangerous" because it could lead to insufficient doses and inadequate courses of therapy, in turn accelerating the development of resistance.
Roche said it took the reports seriously, and was stepping up its own clinical research on Tamiflu's use in humans and animals, including work on dosages of twice the current levels for longer periods. It said findings should be ready early next year.
However, David Reddy, who is responsible for Tamiflu at the company, stressed that any findings on resistance or deaths should be set against the fact that an eventual pandemic strain of H5N1 would be different from the current bird flu virus which has so far infected 139 people and killed 71. (FT Syndication Service)
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