Snowy Owl
Retired in 2010, In Memoriam
Role of combination antiviral therapy in pandemic influenza and stockpiling implications
Why stockpile ion channel inhibitors?
Combination therapy
Costs
Summary points
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http://www.bmj.com/cgi/content/extract/334/7588/293
BMJ 2007;334:293-294 (10 February), doi:10.1136/bmj.39105.428981.BE
Sotirios Tsiodras, lecturer in infectious diseases<SUP>1</SUP>, John D Mooney, public health specialist trainee<SUP>2</SUP>, Angelos Hatzakis, professor<SUP>3</SUP>
<SUP>1</SUP> Fourth Academic Department of Internal Medicine, University of Athens Medical School, Athens 12462, Greece, <SUP>2</SUP> South West Public Health Training Programme, Dorset, <SUP>3</SUP> Department of Hygiene and Epidemiology, University of Athens Medical School
It is impossible to predict which drugs will be effective against<SUP> </SUP>a new pandemic strain of influenza. Sotirios Tsiodras <SUP></SUP>and colleagues argue that failure to stockpile both major<SUP> </SUP>classes of antiviral drugs could prove costly
We currently have two classes of drugs that<SUP> </SUP>are effective against influenza viruses: the M2 ion channel<SUP> </SUP>inhibitors (amantadine and rimantadine) and the neuraminidase<SUP> </SUP>inhibitors (oseltamivir, zanamivir).<SUP>1</SUP> Although ion channel inhibitors<SUP> </SUP>are effective against several subtypes of influenza A viruses,<SUP>2</SUP><SUP> </SUP>they are not being widely stockpiled for a future influenza<SUP> </SUP>pandemic.<SUP>3</SUP> This is because they cause unacceptable side effects<SUP>1</SUP><SUP> </SUP>and their use is associated with a rapid emergence of resistance<SUP>1</SUP><SUP> </SUP><SUP>4</SUP> <SUP>5</SUP> without any demonstrable<SUP> </SUP>reduction in transmissibility or pathogenicity.<SUP>6</SUP> Resistance<SUP> </SUP>of influenza A viruses to amantadine is increasing worldwide,<SUP>7</SUP><SUP> </SUP>and the US Centers for Disease Control and Prevention recommended<SUP> </SUP>against the use of ion channel inhibitors for treatment or prophylaxis<SUP> </SUP>during the 2005-6 influenza season.<SUP>8</SUP> Policy makers and some<SUP> </SUP>medical experts thus consider ion channel inhibitors inappropriate<SUP> </SUP>as first line treatment or prophylaxis for pandemic influenza.<SUP> </SUP>We believe their role should <NOBR>. . .</NOBR> [Full text of this article]BMJ 2007;334:293-294 (10 February), doi:10.1136/bmj.39105.428981.BE
Sotirios Tsiodras, lecturer in infectious diseases<SUP>1</SUP>, John D Mooney, public health specialist trainee<SUP>2</SUP>, Angelos Hatzakis, professor<SUP>3</SUP>
<SUP>1</SUP> Fourth Academic Department of Internal Medicine, University of Athens Medical School, Athens 12462, Greece, <SUP>2</SUP> South West Public Health Training Programme, Dorset, <SUP>3</SUP> Department of Hygiene and Epidemiology, University of Athens Medical School
It is impossible to predict which drugs will be effective against<SUP> </SUP>a new pandemic strain of influenza. Sotirios Tsiodras <SUP></SUP>and colleagues argue that failure to stockpile both major<SUP> </SUP>classes of antiviral drugs could prove costly
Why stockpile ion channel inhibitors?
Summary points
<!--References
--><!-- null -->
<DL><DT>Bird flu and transparency </DT><DD>Fiona Godlee
BMJ 2007 334: 0. <NOBR>[Extract] [Full Text] </NOBR>
</DD></DL><DL><DT>The next best thing </DT><DD>Douglas Kamerow
BMJ 2007 334: 0. <NOBR>[Extract] [Full Text] </NOBR>
</DD></DL><DL><DT>Preparing for the next flu pandemic </DT><DD>Wei Shen Lim, Anne Thomson, and Paul Little
BMJ 2007 334: 268-269. <NOBR>[Extract] [Full Text] </NOBR>
</DD></DL><DL><DT>People exposed to H5N1 in English turkey outbreak get antiviral and vaccination </DT><DD>Susan Mayor
BMJ 2007 334: 275. <NOBR>[Extract] [Full Text] </NOBR></DD></DL>