For flu, vaccines better than antiviral drugs

Katy Masden, six months (C) gets a flu shot from Ellie Duke, public health nurse for Larimer County (L) while sitting on her mother Dana's lap at a clinic in Loveland, Colorado December 12, 2003.

NEW YORK (Reuters Health) - Healthy adults are likely to fare better during the flu season by getting a flu shot than by depending on antiviral drugs to make them feel better, new research from the UK shows.

The research team headed by Dr. Jane Burch found that Tamiflu (oseltamivir), a flu drug made by Swiss-based Roche, and Relenza (zanamivir), made by GlaxoSmithKline, will quash symptoms no more than one day earlier than no drugs at all.

Although the researchers did not compare the benefits of vaccines to the benefits of antiviral drugs, they note that vaccination has the advantage of being a preventive measure. That's part true in those years where there is a "good match" between the vaccine and the influenza virus circulating that year.

As a result, making more people eligible for vaccination "might be a more appropriate choice for healthy adults," the authors state in The Lancet Infectious Diseases, published online on August 8.

The UK National Institute for Health and Clinical Excellence (NICE) asked Burch, at the University of York, UK, and her team to review 26 scientific studies to determine the effectiveness of zanamivir and oseltamivir as treatments for seasonal flu in adults. NICE is responsible for assessing drugs for reimbursement by the state health service.

Flu symptoms went away one half to one day earlier than they would have if no drug had been used.

With results like that, drug treatment is "unlikely to be the most appropriate course of action," Burch and colleagues write. They believe a better policy for healthy adults would be to extend recommendations so that all healthy adult can get one.

In fact, they point out, the findings might be relevant to the current swine flu (H1N1) pandemic.

As a result of this work, NICE now only recommends use of the antiviral treatments for influenza in people considered to be at risk. These include people aged 65 and older, and anyone over 6 months old with other serious health conditions, such as chronic disease affecting the lungs, heart, liver, or kidney, as well as those with diabetes or a suppressed immune system.

Their primary concern, the paper says, is lowering the risk of influenza-related complications, such as pneumonia or exacerbations of other underlying illnesses, though research has yet to prove such a benefit.

In addition to vaccination, Burch's team lists other approaches that may be more effective than starting an anti-viral medication once people are sick. These include having those who are exposed to the flu start one of the medications immediately and making the drugs available over the counter for purchase.

They also propose that family doctors have rapid tests for diagnosing flu on hand. That way, patients won't be treated with a drug that will have no effect at all if they don't even have the flu.

One of the nine members of the research team has received funding from drug companies that make vaccines and antivirals, and another has received "funding from the pharmaceutical industry to attend an influenza-related conference."

SOURCE: The Lancet Infectious Diseases, published online on August 8.