Despite the fact that the problem of influenza prevention has been fairly well studied and that the feasibility of vaccinating populations at increased risk of disease or complications is not questioned, the treatment of this very common disease remains questionable , and for the moment there is no single opinion on a given problem. The chemoprophylaxis of the disease (that is, the use of antiviral chemotherapy drugs for prophylaxis) is also very controversial.
Experts from the British Medical Journal note that the neuraminidase inhibitors, oseltamivir ("Tamiflu", Roche) and zanamivir ("Relenza", GlaxoSmithKline), are clinically effective in the treatment of flu, but have important limitations on indications for use and need further research.
This statement is based on a meta-analysis of 17 studies on the use of neuroaminidase inhibitors (oseltamivir and zanamivir) for treatment and 7 studies on their prophylactic use. Despite the fact that the efficacy in the treatment and prevention of these drugs has been proven, the amount of data on their use in the treatment of certain categories of patients is limited.
Neuraminidase inhibitors have been shown to reduce the duration of uncomplicated disease by approximately one day and reduce the likelihood of complications requiring antimicrobial therapy. In addition, when used for prophylactic purposes, these drugs can reduce the risk of influenza by 70 to 90%, depending on the population targeted by these measures and the duration of their use. However, the results were less convincing for high-risk populations.
There are many obstacles due to which neuraminidase inhibitors are not used in broad therapeutic practice. One of the most important factors is the high cost of therapy and insufficient data on the effectiveness of this group of drugs for preventing serious complications and mortality in high-risk groups, including elderly patients. and patients with concomitant pathology (i.e. in the groups with the highest medical rates). and economic costs in the treatment and prevention of influenza).
Currently, a promising study is underway to develop new neuraminidase inhibitors that will be even more effective, cheaper and easier to administer. It is hoped that this will be done before a new flu pandemic occurs.
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