UK government not convinced by claims for flu drug

Zanamivir in the treatment of influenza

Influenza is a common illness, affecting many people every winter, with a considerable impact on mortality, hospital admissions, healthcare utilisation and sickness absence from work and school. Influenza management is currently focused on annual vaccinations for those in certain risk groups. Risk is determined by age and chronic illness, particularly diabetes, chronic respiratory and cardiac disease, and persons immunocompromised from disease or concomitant therapy. Amantadine (and in some countries, rimantadine is available but has not been widely used, because it is only effective against influenza A infections. The use of amantadines for treatment has been associated with the rapid emergence of resistant viruses capable of transmission, compromising its potential as a prophylactic, as well as a treatment. Side effects are well recognised and are a particular problem in the most vulnerable elderly populations, where dose restriction is necessary and prior knowledge of creatinine clearance desirable. The potential market for a new influenza treatment is large and the potential role of neuraminidase inhibitors in addressing this market has been covered in several review articles [1-4]. This review reports on the introduction of zanamivir (Relenza) to the market with particular reference to experience in the UK.

Update on influenza and other viral pneumonias

Major developments during the past 5 years concerning influenza prevention by vaccination and treatment with neuraminidase inhibitors are reviewed. These have been accompanied by increased media interest in related issues: pressures on hospital admissions, ethical concerns and controls on prescribing limiting professional autonomy. The new live attenuated influenza vaccines, adjuvanted vaccines and the emerging recombinant DNA vaccines are discussed. Recent information on neuraminidase inhibitor antivirals, surveillance for resistant viruses, the prospects for near patient tests (i.e. tests that can be used near the patient to improve immediate patient management or in the laboratory to give rapid feedback for physicians) and the clinical significance of other respiratory viruses are highlighted. The benefits of recent advances provide challenges for health care delivery and public acceptance as great as those involved in their scientific development.