Tamiflu meets the challenge of drug resistance again without limited impact of substitutes

Daily economic news 2013-05-31: Tamiflu and zanamivir have been regarded as the key to h7n9 virus However, the emergence of drug resistance has challenged them Recently, research results from Shanghai Medical College of Fudan University were published on the website of the lancet, a top international medical journal According to the research, it is the first time that h7n9 infection cases resistant to Tamiflu and its similar drugs have been confirmed clinically According to the previous paper, scientists studied 14 h7n9 infected patients admitted to Shanghai public health center With the progress of h7n9 infection, all patients suffered from pneumonia Seven patients were very serious, three of them were particularly critical, and two patients died when the article was published The third patient still needed to maintain life by means of extracorporeal membrane oxygenation In the study of three critically ill patients, it was found that a gene mutation occurred in one of the viruses, leading to the production of drug resistance In addition, the study also found that a patient in the initial infection and take antiviral drugs, carrying ceramidase inhibitor drugs (such as Tamiflu) resistance mutation of the virus immediately appeared, which may be caused by the use of Tamiflu This is a worrying phenomenon: the use of ceramidase inhibitors may lead to the emergence of drug-resistant strains In 2009, the World Health Organization announced to raise the alert level of influenza A (H1N1) to 6 (the highest alert level) Tamiflu became one of the first choice drugs to fight the flu, which also led to a 203% increase in sales in the first half of 2009 Roche, the manufacturer of Tamiflu, recorded US $3 billion in the same year, while zanamivir produced by GlaxoSmithKline recommended another drug, and its sales increased from £ 57 million to £ 720 million In fact, as early as 2009, cases of drug resistance to Tamiflu were found in the United States and the United Kingdom; at the end of 2009, some experts questioned the effectiveness of Tamiflu in the treatment of influenza; in January 2010, EU health officials publicly said that the outbreak of influenza A may be medical "Century scandal", which believes that the "nature" of H1N1 is actually mild, but its harm has been deliberately exaggerated by some pharmaceutical companies; in 2011, medical research of Tokyo University in Japan showed that "Tamiflu" and another antiviral drug, which are widely used as influenza drugs, are widely used Zanamivir is more likely to cause drug-resistant viruses in children with influenza This time, after the emergence of drug-resistant cases, h7n9 in Shanghai According to academician Wen Yumei, leader of the expert group on prevention and treatment of avian influenza and microbiologist, the research results show that Tamiflu treatment is still effective for most of the patients, and should be treated as soon as possible once confirmed; at the same time, it is suggested that before and during the treatment of Tamiflu, close monitoring of viral load and drug-resistant "gene locus" should be carried out, and the treatment scheme should be adjusted in time to improve the success of treatment In addition, it is particularly important to speed up the research and development of new drugs Guo Fanli, a researcher in the pharmaceutical industry of CIC consultant, told the daily economic news that the impact of h7n9 drug resistance variation on the production and sales of Tamiflu would be limited, and there are no other drugs that can replace Tamiflu at present