BIGGER doses of the anti-viral drug Tamiflu may be needed to treat avian flu, the drug group Roche said yesterday after evidence emerged of resistance to the drug.
It may also be necessary to combine the drug with other antiviral agents to treat the H5N1 avian virus, the company said in a statement.
“Roche agrees that other treatment regimens for the H5N1 virus need to be explored, including higher dose and/or longer duration of treatment with Tamiflu, or a combination of antiviral agents,” the company said. Safety data supported the use of higher doses.
A study published in the New England Journal of Medicine, highlighted the deaths of two Vietnamese girls who had become resistant to Tamiflu despite getting the current full dose of treatment. Two more deaths from bird flu in Indonesia were confirmed yesterday, taking the known total to 73. The number of cases, including survivors is 141. All the deaths so far have been in Asia.
The immediate relevance of the finding to a potential world pandemic of flu was not clear. Any pandemic strain will be easier to catch but less virulent than H5N1, and trials of Tamiflu against seasonal flu have shown that in a small proportion of cases, resistance does develop. For adults, the rate of resistance is about 0.4 per cent, and for children under 12, about 4 per cent. The resistant virus is less virulent than the unaltered type, so if Tamiflu is ineffective in these cases it may not matter much.
The implication, if we need to be using larger doses, is that we may have even a greater shortage of the drug.
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