Based on the editors’ criteria of selecting “articles most likely to change clinical practice,” one article of significant interest was selected for the DynaMed Weekly Update.
Evidence for Oseltamivir Reducing Influenza Symptom Duration Still Intact but Evidence about Reducing Complications Questioned
Oseltamivir (Tamiflu) is commonly used for influenza because it has been shown to reduce symptom duration (by about 1 day) and was believed to also reduce complications of influenza. The strongest evidence for reducing complications was a review of 10 trials (Arch Intern Med 2003 Jul 28;163(14):1667). This meta-analysis was the primary supporting data for this conclusion in a Cochrane review (Cochrane Database Syst Rev 2006 Jul 19;(3):CD001265).
Upon updating this Cochrane review, the authors investigated this meta-analysis further and found most of the supporting data to be from unpublished trials. They were unable to obtain the original data despite multiple attempts, so they excluded this data from their analysis. After excluding this data they did not find a statistically significant benefit for oseltamivir for reducing complications, based on a meta-analysis of 3 trials.
The updated Cochrane review still concludes that neuraminidase inhibitors (oseltamivir or zanamivir) reduce the duration of influenza symptoms when started within 48 hours and have efficacy for influenza prophylaxis (BMJ 2009 Dec 8;339:b5106).
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DynaMed Weekly Update is a compilation of 1 to 5 articles that are of significant interest to clinicians.Articles are selected from DynaMed's Systematic Literature Surveillance as articles most likely to change clinical practice. Updates are prepared by the DynaMed Editorial Team which includes 28 clinicians from multiple disciplines. Send comments to DynaMedEditor@ebscohost.com. To learn more about DynaMed, go to www.ebscohost.com/dynamed.
