EXPERTS RECOMMEND STOCKPILING A COMBINATION OF FLU DRUGS

Countries should stockpile a combination of antiviral drugs for use in an influenza pandemic, researchers say in a recent issue of the British Medical Journal (BMJ).

There are currently two classes of drugs that are effective against influenza viruses, according to the article: ion channel inhibitors (amantadine and rimantadine) and neuraminidase inhibitors. Roche's Tamiflu (oseltamivir) and GlaxoSmithKline's Relenza (zanamivir) are neuraminidase inhibitors.

Although ion channel inhibitors are effective against several strains of influenza viruses, they are not being widely stockpiled for a future flu pandemic because they cause unacceptable side effects and their use is associated with a rapid emergence of resistance, the authors say. But researchers argue that combining the two types of drugs may reduce side effects and the risk of resistance, and could play an important role in protecting against a future flu pandemic.

In laboratory tests, the combination of ion channel and neuraminidase inhibitors reduced the emergence of resistance and even prevented the emergence of resistant strains of the highly pathogenic avian influenza H5N1 virus, the authors write.

The World Health Organization recently recommended combined use of ion channel and neuraminidase inhibitors against the H5N1 strain. Several countries, including the UK and Greece, are already stockpiling ion channel inhibitors, and other countries should follow suit, the authors conclude.

An extract of the article is available at www.bmj.com/cgi/content/extract/334/7588/293.