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WHO Backs Older Drugs For Bird-Flu Treatment
posted by admin on 22/05/06

Amantadine and rimantadine alongside to treat bird-flu patients 

The World Health Organization formally endorsed the use of an older class of antiviral drugs alongside Tamiflu to treat some bird-flu patients, capping a months-long reassessment of often-ambiguous data suggesting the older drugs might still have promise. 

The endorsement of amantadine and rimantadine, part of a 138-page report released on Friday with treatment recommendations, comes as doctors continue to wrestle with the H5N1 virus, a deadly strain of avian influenza that in a very small number of cases has passed from birds to humans. 

Some scientists believe that H5N1, which has killed roughly one of every two people it infects, could cause a human pandemic if it mutates to spread easily among people, and health authorities and governments have sought to arm themselves against the possibility with the most effective drugs. 

Tamiflu, made by Roche Holding AG of Switzerland, remains the WHO's drug of choice for treating bird-flu victims. The WHO's endorsement helped sales of the drug surge last year to $1.2 billion as governments scrambled to stockpile medications. Amid alarm over limits on the supply of Tamiflu, Roche agreed last year to license the drug's manufacture to other companies and has been ramping up supply. 

The new WHO recommendations, however, give doctors another weapon against a disease that has killed some people even though they have taken Tamiflu. The United Nations health agency, based in Geneva, now says that doctors might consider giving patients either amantadine or rimantadine, in addition to Tamiflu, in places where genetic analyses of circulating strains of the virus show that the older class of drugs could work. In addition, the WHO says that doctors might consider using those older drugs, which are far cheaper than Roche's branded product, to treat patients when Tamiflu isn't available. 

Roche has said that so far all the strains of H5N1 that have been examined would be susceptible to Tamiflu. 

In apparent anticipation of an increase in demand for the older drugs, Kenneth E. Goodman, president and chief operating officer of Forest Laboratories Inc. in New York, which makes a branded version of rimantadine called Flumadine, wrote a letter dated May 8 to U.S. Health and Human Services Secretary Michael Leavitt saying that "commercial demand for rimantadine has declined substantially and, therefore, Forest is producing very little product today." As a result, Mr. Goodman wrote, the company would need advance notice from the U.S. government if a significant order for the drug was placed. 

The WHO said its new recommendation was made placing "a high value on the prevention of death in an illness with a high case fatality," given that no data from controlled clinical trials are available. 

Write to Nicholas Zamiska at

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