For years (and especially during the recent swine or avian flu pandemic panic) Tamiflu (Roche) and Relenza (GSK) have been the drugs of choice to treat flu patients with severe complications like pneumonia. Governments all over the world bought and stored the drugs to be prepared. But, apparently, the data proving the efficacy of these drugs are weak! Nike Heinen (a freelance) quotes a report of the Cochrane Collaboration, a group of scientists “preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health care”.
The article, published (in slightly different versions) by Süddeutsche Zeitung, Basler Zeitung (Tages-Anzeiger), and Badische Zeitung, explains in detail the astonishing career of these now Billion-Dollar-Blockbusters. However, in 2009, Heinen reports, the Cochrane scientists got hints that the important “Kaiser-review” might be flawed. A team lead by the virologist Laurent Kaiser from the University of Geneva had summarized 10 Tamiflu-studies (all done by Roche). In 2003, his conclusion was, that the drug has a beneficary effect compared to placebo. First, the Cochrane scientists trusted Kaisers conclusions. But after they were tipped off that five authors of the Kaiser-review were on Roche’s payroll and that not all the reviewed data came from peer reviewed journals, they asked Roche for the raw data. Roche denied the request, because the Cochrane scientists refused to sign a contract, that would bind them to maintain silence about any of their findings after review of the data. In December 2009, the scientists reported their objections at the British Medical Journal (BMJ) but raw data from Roche is still not openly available.
The Cochrane collaboration is not only concerned about a possible lack of efficacy and billions of Dollars spent on drugs without a substantial effect compared to placebo pills. Some of the publicly available data about Tamiflu also report substantial side effects in at least ten cases, three of them connected with Tamiflu.
Regarding Relenza, the comparable flu drug from GlaxoSmithKline, the data do not seem to provide any better evidence. According to the Cochrane scientists, there are hints of data manipulation, too, and GSK’s major US study of Relenza did not show any efficacy – and never got published.
Sounds like a scoop, right? And it reads as such, first (“exclusive”, claims the Basler Zeitung). But unfortunately, the reader does not get a hint, that the article is not the first one picking up the criticism of the Cochrane scientists (have a look at Der Spiegel or the LA Times blog or Science’s news section etc.).
The New Scientist even included some criticism of the Cochrane allegations and some data to judge the re-evaluated efficacy estimations. Stuff, that I missed in the update article.
But don’t get me wrong, I liked the article, because it is still worth it to remind the public about the unsettled concerns with Tamiflu and Relenza. Especially, the nervous reaction of Roche hints that it would be worth it to dig even deeper…
Sascha Karberg
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