Drugs used to treat the flu really did save the lives of seriously ill people during the influenza pandemic of 2009-2010, a study in The Lancet Respiratory Medicine suggests.
Adults who promptly received doses of Tamiflu, Relenza or related drugs were half as likely to die in the hospital as people who were not treated. The study analyzed 78 different studies from 38 countries to reach this conclusion.
Why, you might wonder, is it news that a drug approved to treat the flu actually worked?
Well, there's been a simmering controversy, particularly in Britain, over whether the billions of dollars spent on these drugs has been worthwhile. Some independent scientists have challenged the governments' conclusions about the value of these medicines — in particular, they question whether the drugs actually prevent flu. This latest study is about treatment, not prevention.
"Many governments have stockpiles of Tamiflu that are close to expiry. But until now, they had no adequate data to assist them in deciding if lives were saved in 2009-2010 or not, and whether they should replenish or not," said Jonathan Nguyen-Van-Tam, from the University of Nottingham, in a statement accompanying his new paper on the subject.
The study is another in a line that shows these drugs do, indeed, benefit people who get sick with the flu — at least adults. Findings for children were not definitive.
The 2009-10 epidemic, a type of swine flu, spread from Mexico and throughout a world that initially had no vaccine effective against the strain. Untold millions of people fell ill. Scientists at the Centers for Disease Control and Prevention estimate that between 151,000 and 575,000 people died from that pandemic flu. Unlike most strains of flu, which are worst among people older than 60, this strain sickened primarily people younger than that. People who ended up in the hospital were often treated with anti-viral drugs called neuraminidase inhibitors, including brand-names Tamiflu and Relenza.
Nguyen-Van-Tam's study found that adults who were treated with the drug within two days of diagnosis reduced their risk of death by half, compared with people who didn't get treated at all. And promptness counts.
"As expected, early treatment seems to be optimal, and treatment shouldn't be delayed by even one day to wait for diagnostic test results," writes Alicia Fry of the CDC, in an editorial accompanying the study. She adds that there still might be some benefit to treating people after that, especially if they are severely ill.
Children didn't benefit so clearly from treatment. The study hinted that the drug reduced the risk of death among children, but the effect was too weak to measure with confidence. Still, Dr. Fry writes that it's worth treating children because the potential benefits outweigh the drugs' low risks.
The CDC says most flu viruses circulating this year can be treated with Tamiflu and related drugs, though a few rare strains of flu are resistant to these medicines.
The study was funded by Hoffman La Roche, which owns Genentech, the maker of Tamiflu. That's a sensitive point because other scientists have struggled to get data out of Roche in order to make an independent assessment of Tamiflu.
Anticipating raised eyebrows, the paper says: "The funder of the study had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The funder has not and will never have access to the data."