New Study Suggests Many Flu Antivirals May Not Lead to Better Outcomes Than Standard Care

A new network meta-analysis of trials “comparing the effectiveness of flu antivirals suggests that only baloxavir (Xofluza) may be better than standard care or a placebo in reducing the risk of hospitalization for high-risk patients with non-severe flu and likely speeds symptom relief with few or no adverse effects but may increase antimicrobial resistance in 10% of recipients.” CIDRAP has the release.

Flu antiviral experts are taking issue with conclusions drawn about oseltamivir (Tamiflu), however. James Antoon, assistant professor of pediatrics at Vanderbilt University Medical Center, states that there is “very, very strong evidence that oseltamivir decreases duration of symptoms in adults and children and that both of those medications can decrease complications of influenza, such as pneumonia, sinusitis, and ear infections.

The network meta-analysis involved researchers analyzing “pooled data from 73 randomized clinical trials published from 1971 to 2023 involving 34,332 participants.” The study authors wrote that “all antiviral drugs had little or no effect on mortality for low-risk patients and high-risk patients (all high certainty).” Ultimately, they concluded that their “findings support the use of baloxavir for treatment of high-risk patients with nonsevere influenza.”

Antoon stated that, since a network meta-analysis “differs from a traditional meta-analysis, which focuses on direct comparisons,” the conclusions reached in this study may have been “watered down” compared to traditional meta-analyses, which “have found very similar effectiveness as far as duration of symptoms.”