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Famoso antiviral, pero poco utilizado
M. R. S. - Madrid - 21/12/2009
Cuando la Organizaci?n Mundial de la Salud, en abril, iba subiendo los niveles de alerta al mismo ritmo que el H1N1 se extend?a por el mundo, Sanidad tomaba la decisi?n de retirar de las farmacias el Tamiflu y el Relenza. Esos dos f?rmacos antivirales se hab?an demostrado eficaces para el tratamiento de la nueva gripe y el Gobierno quer?a evitar que la poblaci?n hiciese acopio de ellos.
Desde entonces y hasta el pasado 1 de noviembre s?lo los enfermos con alg?n factor de riesgo o con s?ntomas graves de gripe han tenido acceso a estos medicamentos que se daban ?nicamente en centros de salud y hospitales. En esas circunstancias y hasta mediados de noviembre se han dispensado s?lo 6.000 tratamientos completos. Una cifra que los expertos consideran ?nfima.
Con las compras del Gobierno, su restricci?n y su vuelta a las farmacias, el Tamifllu ha estado en boca de todos. Pero s?lo de manera figurada. "Espa?a ha sido especialmente restrictiva con estos f?rmacos. El n?mero que se ha dispensado es realmente muy bajo", opina Antoni Trilla, epidemi?logo y director de Calidad y Seguridad Cl?nica del hospital Cl?nic de Barcelona. S?lo las embarazadas, los enfermos cr?nicos o las personas que acud?an al m?dico con s?ntomas graves han tomado Tamiflu. Pero, seg?n sostiene Trilla, ni siquiera se les ha dado a todos ellos. "Los indicadores de tratamiento, por ejemplo, ser enfermo cr?nico, incluyen un n?mero mucho m?s elevado de pacientes que los realmente tratados. Estamos ante un caso de infrautilizaci?n del f?rmaco", a?ade.
En noviembre, seg?n los datos de Sanidad, m?s de 750.000 personas hab?an pasado la nueva gripe. S?lo el 0,8% de ellas tomaron antivirales. Una cifra muy alejada a la de c?mo se ha utilizado en otros pa?ses de Europa. "En Alemania, una extrapolaci?n del uso de estos f?rmacos en campa?as precedentes de gripe estacional permite calcular que, en esta pandemia, se han usado de 80.000 a 400.000 dosis, y en Francia de 50.000 a 250.000", dice Juan Mart?nez Hern?ndez, experto en Salud P?blica y Medicina Preventiva y asesor para la nueva gripe de la Organizaci?n M?dica Colegial.
As?, Espa?a sigue guardando la mayor?a de los 15 millones de tratamientos completo. "Se compraron para hacer campa?a y tranquilizar a la poblaci?n, pero no se ha hecho nada para que se utilicen correctamente", dice Mart?nez Hern?ndez quien sostiene que muchos enfermos graves no hubiesen llegado a la UCI si hubiesen tomado Tamiflu.
La OMS recomienda la dispensaci?n de los antivirales en las primeras 48 horas desde que aparecieron los primeros s?ntomas. Una premisa que, seg?n Trilla no se cumple. Y es en ese tiempo, cuando Tamiflu y Relenza son eficaces. "Algunos profesionales no han tenido claro el proceso para prescribir el f?rmaco. Tampoco se ha informado bien sobre estos medicamentos", argumenta Mart?nez Hern?ndez. En Espa?a, a diferencia de otros pa?ses, no hay tradici?n de tomar antivirales para tratar la gripe. En otras campa?as se utilizaba tan poco que en ?sta, a pesar de que su uso no ha sido masivo, han aumentado un 87% su compra en las farmacias.
Pero el Tamifllu es un f?rmaco pol?mico. Dada la novedad del H1N1 no abundan los estudios que aseguren su eficacia real. Hace unos d?as la prestigiosa revista British Medical Journal publicaba un art?culo que recog?a varios estudios que pon?an en duda su efectividad y reclamaban m?s an?lisis cient?ficos. Tambi?n reprobaba la decisi?n de muchos Gobiernos de dedicar sus fondos a la compra de este producto: "Cuando grandes cantidades de dinero p?blico, y grandes cantidades de la confianza del p?blico, se invierten en f?rmacos, los datos completos deben ser accesibles para su revisi?n por la comunidad cient?fica".
En espera de la divulgaci?n completa y de un examen independiente de los datos de Roche, los riesgos y beneficios de oseltamivir siguen siendo inciertos
Fuente: El Mundo
Antiviral famous but seldom used
MRS - Madrid - 21/12/2009
When the World Health Organization in April, was raising alert levels at the same rate as the H1N1 spread throughout the world, Health took the decision to withdraw from the drug Tamiflu and Relenza. Those two antiviral drugs had proved effective in the treatment of flu and the government wanted to prevent people from gathering hiciese them.
From then until Nov. 1 and only in patients with any risk factors or with severe symptoms of influenza have had access to these drugs were given only in hospitals and health centers. In these circumstances and until mid-November, only 6,000 have extended treatment courses. A figure that experts consider negligible.
With purchases of government restriction and its return to retail pharmacies, the Tamifllu has been on everyone's lips. But only figuratively. "Spain has been particularly restrictive with these drugs. The issue that has been dispensed is very low indeed," says Antoni Trilla, epidemiologist and director of Clinical Quality and Safety of Hospital Cl?nic de Barcelona. Only pregnant women, chronically ill or people who went to the doctor with severe symptoms have taken Tamiflu. But, as argued by Trilla, not even been given to them all. "Indicators of treatment, such as being chronically ill, including a much larger number of patients who actually treated. This is a case of underutilization of the drug," he adds.
In November, according to data from Health, more than 750,000 people had passed the new flu. S?lo el 0,8% de ellas tomaron antivirales. Only 0,8% of them took antivirals.. A figure far removed from that of how it is used in other European countries. "In Germany, an extrapolation of the use of these drugs in previous campaigns seasonal influenza can calculate that in this epidemic, have been used from 80,000 to 400,000 doses, and in France from 50,000 to 250,000", says Juan Martinez Hernandez, an expert in Public Health and Preventive Medicine and consultant on the new flu College of Physicians.
Thus, Spain is keeping most of the 15 million treatment courses. "Purchased to campaign and to reassure the population, but has not done anything to it is used correctly," says Martinez Hernandez, who maintains that many critically ill patients had not reached the ICU if they had taken Tamiflu.
WHO recommends the delivery of antivirals in the first 48 hours after symptoms first appeared. A premise that, according Trilla fails. And at that time, as Tamiflu and Relenza are effective. "Some professionals have no clear process for prescribing the drug. Nor is fully informed about these drugs," argues Martinez Hernandez. In Spain, unlike other countries, there is no tradition of taking antivirals for treating influenza. In other campaigns are used so little that in this, although its use has not been massively increased by 87% your purchase at pharmacies.
But Tamifllu is a controversial drug. Given the novelty of H1N1 not many studies to ensure its effectiveness. A few days ago the prestigious British Medical Journal published an article taking a number of studies that cast doubt on their effectiveness and calls for more scientific analysis. Also criticizing the decision of many governments to allocate their funds to buy this product: "When large amounts of public money, and large amounts of public trust, invested in on drugs, all data must be accessible for review by the scientific community. "
Pending full disclosure and independent review of data from Roche, the risks and benefits of oseltamivir remain uncertain
Source: El Mundo
M. R. S. - Madrid - 21/12/2009
Cuando la Organizaci?n Mundial de la Salud, en abril, iba subiendo los niveles de alerta al mismo ritmo que el H1N1 se extend?a por el mundo, Sanidad tomaba la decisi?n de retirar de las farmacias el Tamiflu y el Relenza. Esos dos f?rmacos antivirales se hab?an demostrado eficaces para el tratamiento de la nueva gripe y el Gobierno quer?a evitar que la poblaci?n hiciese acopio de ellos.
Desde entonces y hasta el pasado 1 de noviembre s?lo los enfermos con alg?n factor de riesgo o con s?ntomas graves de gripe han tenido acceso a estos medicamentos que se daban ?nicamente en centros de salud y hospitales. En esas circunstancias y hasta mediados de noviembre se han dispensado s?lo 6.000 tratamientos completos. Una cifra que los expertos consideran ?nfima.
Con las compras del Gobierno, su restricci?n y su vuelta a las farmacias, el Tamifllu ha estado en boca de todos. Pero s?lo de manera figurada. "Espa?a ha sido especialmente restrictiva con estos f?rmacos. El n?mero que se ha dispensado es realmente muy bajo", opina Antoni Trilla, epidemi?logo y director de Calidad y Seguridad Cl?nica del hospital Cl?nic de Barcelona. S?lo las embarazadas, los enfermos cr?nicos o las personas que acud?an al m?dico con s?ntomas graves han tomado Tamiflu. Pero, seg?n sostiene Trilla, ni siquiera se les ha dado a todos ellos. "Los indicadores de tratamiento, por ejemplo, ser enfermo cr?nico, incluyen un n?mero mucho m?s elevado de pacientes que los realmente tratados. Estamos ante un caso de infrautilizaci?n del f?rmaco", a?ade.
En noviembre, seg?n los datos de Sanidad, m?s de 750.000 personas hab?an pasado la nueva gripe. S?lo el 0,8% de ellas tomaron antivirales. Una cifra muy alejada a la de c?mo se ha utilizado en otros pa?ses de Europa. "En Alemania, una extrapolaci?n del uso de estos f?rmacos en campa?as precedentes de gripe estacional permite calcular que, en esta pandemia, se han usado de 80.000 a 400.000 dosis, y en Francia de 50.000 a 250.000", dice Juan Mart?nez Hern?ndez, experto en Salud P?blica y Medicina Preventiva y asesor para la nueva gripe de la Organizaci?n M?dica Colegial.
As?, Espa?a sigue guardando la mayor?a de los 15 millones de tratamientos completo. "Se compraron para hacer campa?a y tranquilizar a la poblaci?n, pero no se ha hecho nada para que se utilicen correctamente", dice Mart?nez Hern?ndez quien sostiene que muchos enfermos graves no hubiesen llegado a la UCI si hubiesen tomado Tamiflu.
La OMS recomienda la dispensaci?n de los antivirales en las primeras 48 horas desde que aparecieron los primeros s?ntomas. Una premisa que, seg?n Trilla no se cumple. Y es en ese tiempo, cuando Tamiflu y Relenza son eficaces. "Algunos profesionales no han tenido claro el proceso para prescribir el f?rmaco. Tampoco se ha informado bien sobre estos medicamentos", argumenta Mart?nez Hern?ndez. En Espa?a, a diferencia de otros pa?ses, no hay tradici?n de tomar antivirales para tratar la gripe. En otras campa?as se utilizaba tan poco que en ?sta, a pesar de que su uso no ha sido masivo, han aumentado un 87% su compra en las farmacias.
Pero el Tamifllu es un f?rmaco pol?mico. Dada la novedad del H1N1 no abundan los estudios que aseguren su eficacia real. Hace unos d?as la prestigiosa revista British Medical Journal publicaba un art?culo que recog?a varios estudios que pon?an en duda su efectividad y reclamaban m?s an?lisis cient?ficos. Tambi?n reprobaba la decisi?n de muchos Gobiernos de dedicar sus fondos a la compra de este producto: "Cuando grandes cantidades de dinero p?blico, y grandes cantidades de la confianza del p?blico, se invierten en f?rmacos, los datos completos deben ser accesibles para su revisi?n por la comunidad cient?fica".
En espera de la divulgaci?n completa y de un examen independiente de los datos de Roche, los riesgos y beneficios de oseltamivir siguen siendo inciertos
Fuente: El Mundo
Antiviral famous but seldom used
MRS - Madrid - 21/12/2009
When the World Health Organization in April, was raising alert levels at the same rate as the H1N1 spread throughout the world, Health took the decision to withdraw from the drug Tamiflu and Relenza. Those two antiviral drugs had proved effective in the treatment of flu and the government wanted to prevent people from gathering hiciese them.
From then until Nov. 1 and only in patients with any risk factors or with severe symptoms of influenza have had access to these drugs were given only in hospitals and health centers. In these circumstances and until mid-November, only 6,000 have extended treatment courses. A figure that experts consider negligible.
With purchases of government restriction and its return to retail pharmacies, the Tamifllu has been on everyone's lips. But only figuratively. "Spain has been particularly restrictive with these drugs. The issue that has been dispensed is very low indeed," says Antoni Trilla, epidemiologist and director of Clinical Quality and Safety of Hospital Cl?nic de Barcelona. Only pregnant women, chronically ill or people who went to the doctor with severe symptoms have taken Tamiflu. But, as argued by Trilla, not even been given to them all. "Indicators of treatment, such as being chronically ill, including a much larger number of patients who actually treated. This is a case of underutilization of the drug," he adds.
In November, according to data from Health, more than 750,000 people had passed the new flu. S?lo el 0,8% de ellas tomaron antivirales. Only 0,8% of them took antivirals.. A figure far removed from that of how it is used in other European countries. "In Germany, an extrapolation of the use of these drugs in previous campaigns seasonal influenza can calculate that in this epidemic, have been used from 80,000 to 400,000 doses, and in France from 50,000 to 250,000", says Juan Martinez Hernandez, an expert in Public Health and Preventive Medicine and consultant on the new flu College of Physicians.
Thus, Spain is keeping most of the 15 million treatment courses. "Purchased to campaign and to reassure the population, but has not done anything to it is used correctly," says Martinez Hernandez, who maintains that many critically ill patients had not reached the ICU if they had taken Tamiflu.
WHO recommends the delivery of antivirals in the first 48 hours after symptoms first appeared. A premise that, according Trilla fails. And at that time, as Tamiflu and Relenza are effective. "Some professionals have no clear process for prescribing the drug. Nor is fully informed about these drugs," argues Martinez Hernandez. In Spain, unlike other countries, there is no tradition of taking antivirals for treating influenza. In other campaigns are used so little that in this, although its use has not been massively increased by 87% your purchase at pharmacies.
But Tamifllu is a controversial drug. Given the novelty of H1N1 not many studies to ensure its effectiveness. A few days ago the prestigious British Medical Journal published an article taking a number of studies that cast doubt on their effectiveness and calls for more scientific analysis. Also criticizing the decision of many governments to allocate their funds to buy this product: "When large amounts of public money, and large amounts of public trust, invested in on drugs, all data must be accessible for review by the scientific community. "
Pending full disclosure and independent review of data from Roche, the risks and benefits of oseltamivir remain uncertain
Source: El Mundo
