By Steve Sternberg
SAN FRANCISCO — Scientists are racing to launch the first major trials of a multi-drug flu cocktail to see if it can prevent complications in high-risk H1N1 (swine flu) patients, researchers said Sunday.
All three of the drugs — amantadine, ribavirin and Tamiflu — are already on the market. All are mainstays of flu treatment that have lost much of their punch because of flu viruses’ ability to throw up new defenses against antivirals. But research reported Sunday suggests that doctors may be able to breach viruses’ defenses by using them together.
Researchers said the triple combination is broadly effective against many different flu viruses, even those resistant to one or more of the drugs in the combo. The most unexpected finding was that each drug appears to regain some measure of its effectiveness against resistant viruses when given with the other two drugs, said lead researcher Mark Prichard of the University of Alabama-Birmingham.
“We were frankly very surprised,” Prichard told participants at a meeting of the American Society for Microbiology.
Secretary of Health Kathleen Sebelius on Sunday offered an upbeat vaccine report, saying on ABC’s This Week that some flu shots may arrive the first week of October, a few days earlier than expected.
Nancy Cox of the Centers for Disease Control and Prevention said the first shipments will be small and reserved for priority groups such as young people and pregnant women “as far as possible.” She said evidence that one shot offers protection was a big confidence-booster that prompted the government to speed up its timetable.
Tests of the triple-drug combo are underway in the Southern Hemisphere and are starting in the USA, Canada and Europe, said virologist Amy Patick of Adamas Pharmaceuticals in Emeryville, Calif. Adamas sponsored the tests using a fixed-dose mix of amantadine and ribavirin and Roche’s Tamiflu. Researchers will pit the combo against Tamiflu alone in 250 people at 40 medical centers.
Jon McCullers of St. Jude Children’s Research Hospital in Memphis said Adamas has asked him to take part. Doctors may now use combination therapy, he said, but so far they haven’t had to because in most cases Tamiflu alone is effective against swine flu which is still vulnerable to it.
Combo therapy will be most useful when swine flu develops resistance to Tamiflu or when more drug-resistant viruses begin to circulate, crowding swine flu out, he said.
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