Use of neuraminidase inhibitors in influenza
The Academy of Medical Sciences (UK) OCT 2015
- Pandemic influenza tops the UK’s National Risk Register due to the probability of a pandemic occurring and the social and economic disruption that could result from an influenza strain causing severe disease. The principal class of antivirals licensed for the treatment and prophylaxis of seasonal and pandemic influenza are neuraminidase inhibitors (NAIs), specifically oseltamivir (trade name: Tamiflu) and zanamivir (trade name: Relenza).
- Questions have been raised for some years about the efficacy and effectiveness of these NAIs and whether this justifies their being part of the UK government’s response to influenza, and particularly whether the government is justified in stockpiling them. The Cochrane Collaboration’s publication, in April 2014, of meta-analyses of randomised controlled trials (RCTs) of the use of oseltamivir and zanamivir during seasonal influenza, in part reactivated this debate. Three further publications of analyses of the use of NAIs for treatment and prophylaxis, which use data from RCTs conducted during seasonal influenza outbreaks and observational data collected during the 2009 H1N1 pandemic, have added to the evidence base and debate.
- In response to a request from the UK Department of Health, a small, independent steering group was established by the Academy of Medical Sciences and the Wellcome Trust to provide commentary on the implications of these new analyses, consider the pipeline for new treatments for influenza, and identify research priorities. The steering group was informed by a one-day workshop held in February 2015 and attended by the authors of the recent key studies as well as a range of individuals from clinical disciplines, public health, virology, industry and research funders.
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