Saturday, March 12, 2016

Tamiflu: What's the score?

Influenza is a very common disease which can effect all age groups and populations in the US.  While being very common, there are not many treatments available and most patients are treated supportive care.  However, Tamiflu is a neuraminidase inhibitor which is FDA approved for flu patients within 36 hours of onset of symptoms.  In my personal experience it is rarely given to healthy adults with the flu and I wonder about the true benefit in otherwise healthy adults with the flu.

This is the perfect setup for a Treatment Score.  The first step is to set my diagnosis as influenza diagnosed patients and my primary outcome statistic to reduction in time to cure.  I was able to find 3 large, randomized controlled trials of Tamiflu given to patients within 36 hours of onset of the flu.  The findings were between 4-30% reduction in the time to cure, typically shortening the course by about 30 hours.  These studies were entered into Star Blocks and the Treatment Score of 25 was given.

This is great, but we also need to account for the side effects of Tamiflu.  I included one large RCT into the Star Block which showed a 41% increase in nausea in patients taking Tamiflu.  Nausea seems much less significant than the flu, so the Treatment Score was decreased by 5% to account for this side effect.  This leaves us with a Treatment Score of 20 for Tamiflu.

Overall, the evidence shows that Tamiflu is effective at decreasing the duration of disease, but there is an increase in nausea related to treatment.  This data should be used for educational purposes only, see your physician for treatment recommendations in your case. (See the disclaimers below.)

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