October 24, 2018

Background:  Oseltamivir (Tamiflu), a neuraminidase inhibitor, was approved by the FDA in 1999.  The majority of the evidence supporting the use of the medication came from trials funded by Roche, the maker of the drug. Safety issues with the drug began sprouting up in 2009, due to case reports in Japan of neuropsychiatric events and these events eventually led to a label warning. The Cochrane collaboration published analyses of the available data in 1999, 2003, and 2006, supporting the use of the drug. However, in 2009, the  Cochrane collaboration began to question Roche about the completeness of the data they were using, which was data from another meta-analysis with 10 RCTs.  Only 2 of those RCTs (Nicholson 2000 and Treanor 2000) were published in peer-reviewed journals.  The other 8 RCTs were presented as proceedings of congress or abstracts in meetings.  Cochrane decided to undertake a complete analysis of full clinical trial data, but had difficulties accessing the data until 2013.  This post will serve as a review of the evidence for and against the use of Oseltamivir (Tamiflu) after the full clinical trial data was finally released.

March 9, 2015

Welcome to the March 2015 REBEL Cast, where Swami, Matt, and I are going to tackle a couple of topics that come up frequently in clinical practice in the emergency department. Today we are going to specifically tackle:
  • Topic #1: Oseltamivir (Tamiflu) in the Treatment of Influenza
  • Topic #2: Use of the HEART Score in Low Risk Chest Pain Patients