Neuraminidase inhibitors for influenza A and B: PROSE may be as useful  as POEMs

doi:10.1136/bmj.327.7406.105-b

BMJ 2003;327:105 (12 July), doi:10.1136/bmj.327.7406.105-b

Letter

Neuraminidase inhibitors for influenza A and B

PROSE may be as useful as POEMs

The first 150 words of the full text of this article appear below.

EDITOR—Perhaps the BMJ would consider publishing PROSEas well as POEMs: pharmaceutical-driven research offering specious evidence.¹

Preventing and treating influenza with "amivirs" would be an example.

Since these drugs are the subject of guidance from NICE in 1999and 2000, as well as an editorial based on a NICE commissionedstudy, both in the BMJ of 7 June,^{2
3} patients and doctors might be forgiven for thinking they are helpful. Their provedbenefit amounts to one day less (out of an average of six)of feeling unwell from flu when used as treatment and a reducedodds ratio for healthy subjects of getting flu when used asprevention: no fewer complications, no fewer deaths.

How were these clinically irrelevant results ever graced withNICE guidance? And how did the drugs attract the epithet ofclinically effective based on these outcomes? This is the exactopposite of evidence that matters.

. . . [Full text of this article]

Nick C Bradley, general practitioner

Ide Lane Surgey, Exeter EX2 8UP nickbradley@eclipse.co.uk

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