LETTER TO THE EDITOR: Do we need a replacement medication for influenza with good efficacy?

In the first quarter of 2014, Cochrane collaboration, the independent, non-profit and non-governmental organization reported that Tamiflu (with the generic name of Oseltamivir) is not working effectively [1]. Furthermore, it was causing side effects including vomiting, nausea, headache, renal problems, psychiatric events, and the risk of other serious complications such as pneumonia when used for the treatment and prophylaxis of influenza. In addition, it may induce serious heart rhythm problems as the drugs regulator claims. The medicine was given to millions of people during the swine flu pandemic. However, Roche the Swiss drug manufacturer disagree with the overall conclusion [2] and are awaiting the decisions from international centers and health organizations. In the very recent article that was published in The Lancet Respiratory Medicine’s website by a large group of “PRIDE” consortium investigators that was funded by F Hoffmann-La Roche, the effectiveness of Tamiflu was revealed [3]. In this study, regardless of its aforementioned side effects, the importance of the neuraminidase inhibitor in the treatment of influenza A (H1N1) and the reduction in mortality rate due to influenza was discussed. Eventually, they concluded that oral Tamiflu (oseltamivir) might reduce mortality compared with no treatment. Regardless of this, the medicine is still prescribed (as tablets) to patients worldwide and is stocked until the purchased batches pass their expiry date [1]. It is worth noting that governmental departments such as the National Health Services (NHS) from the British government spent millions of Sterling Pounds on stockpiling the medicine in the case of a flu outcry [2]. Therefore, being risky is considered to be better than nothing if another viral pandemic suddenly becomes an epidemic, such as in the case of the corona virus [4,5].