It doesn't have to be EviDense.

Abstract

Although we all use oseltamivir with regularity in the winter, there remains controversy surrounding outcomes after treatment. For this one, we look to the adult literature. ### The study. This meta-analysis was conducted to assess the effect of oseltamivir on duration of symptoms, complications, and hospitalizations in adults and included all published and unpublished randomized, double-blinded, placebo-controlled trials that compared oseltamivir with placebo in patients with suspected or confirmed influenza. ### The key findings. Eleven studies (4769 patients) met the meta-analysis criteria. Five studies reported duration of symptoms in the intention-to-treat (ITT) population with a mean reduction of 21 hours (confidence interval 13.3–28.0; I 2 = 0%). Risk difference between oseltamivir and placebo was not statistically significant for patients requiring additional hospitalization or developing pneumonia. #### Why do we care? The drug costs roughly $100 per course, for what amounts to less than a day of symptom relief without a corresponding decrease in hospitalization due to respiratory complications, sepsis, or dehydration. Furthermore, adverse effects of oseltamivir, such as nausea and vomiting, occur in at least 10% of patients. The authors also found that high-quality, unpublished randomized controlled trial performed by the manufacturer demonstrated a less favorable treatment effect than did the published literature. #### Straight from the author’s mouth... “Much of the literature was never published...shameful frankly. All studies …