Arbidol resists, but loses

General Director OJSC «Pharmstandart-lexere» E.F. Passage sent a letter threatening Professor Vasily Vlasov's persecution in connection with the interview with TV Center TV channel at the end of January of this year, in which the Vlasov led as an example of drugs that do not have reliably established efficiency, arbidol. In high-quality and professional press, longer lists are given, which are then widely quoted in other publications. But since it is the Arbidol now actively advertise, Vasily Vlasov prepared for colleagues and potential consumers of Arbidol information on what a drug with proven efficacy (effectiveness) is. What tests of the drug need to be done so that it can be said about him as a means, successfully passed benign tests. The professor also analyzed briefly available information on the clinical efficiency of the Arbitol.

The effectiveness of any medicinal product is established during benign tests. These are primarily double blind randomized multicenter placebo-controlled tests with sufficient power, with a pre-published and officially registered protocol. In such trials, there is a need because other, simpler studies do not give grounds for confidence in the effectiveness of the medication. For example, in simplified tests, it was found that women's sex hormones (estrogens) defend older women from cardiovascular diseases. When they conducted benign tests, it turned out, on the contrary - they bring additional heart attacks, Alzheimer's disease and many other problems, including cancer. This is not the only example of how the benefit has been noticeable with a simplified study, and when they spent a good test - the benefit did not turn out.

Sometimes pharmaceutical companies in the desire to attract more attention to their drug and increase sales deliberately hide from publication the results of studies that question the effectiveness of the drug and, on the contrary, re-publish research materials in which an attractive result is obtained. Not surprisingly, that those studies that are funded by pharmaceutical companies represent their medicines in the best light than those studies that are conducted by independent specialists. This is repeatedly shown in the analysis of publications. It should be noted that in Russia, unlike other developed countries, there is a unique legislation, allowing drug testing only to manufacturers themselves. From this clearly implies the conclusion: all studies conducted in Russia were financed by manufacturers, and therefore reflect their interests, and not scientific truth.

Manufacturers of the Arbitol - the drug is not new on the market for decades, but who came to the market champions thanks to wonderful marketing in recent years - sell legitimate goods. The drug is officially registered and test results were presented at registration. It is so, but registration does not mean evidence of effectiveness. In Russia, it is possible to register drugs, never experienced in benign tests (double-blind randomized multicenter), since registration requirements do not include. Recall the Corvalol, Validole, Cerebrolysis and T.D. It is precisely because registration in Russia, nor in England - everywhere - does not guarantee the effectiveness of the drug, in addition to the drug registration system, there are still formulations, t.E. Lists of drugs recommended for use, clinical guidelines, standards, conduct systematic reviews, recheck the efficiency of drugs in repeated, independent test manufacturer.

Research

But maybe new Research of the Arbidol? In order to make sure that we have not missed anything about the arbidol, we will conduct a search in MEDLINE. This can do any, because on the Internet this best database is available for free thanks to American taxpayers. To do this, we will search for publications mentioning Arbidol and labeled as randomized controlled tests (RCI).

This search gives only four finds.

Two publications - new, 2008. Both - fragmentary describe one study l.IN. Colobukhina with co-authors where Viferon medicine was examined, and found that he is a little more efficient to the arbidol. True, only 101 people were included in the study, t.E. It was about 30 people in the group, and blinding was not, t.E. Patients apparently knew what they were treated. The source of financing of this study is unclear, but it has been published twice in different magazines.

Another study - T.BUT. Semenenko with co-authors (2005), where again in the small number of patients (125) and without blindness investigated the effectiveness of vaccination against influenza and (or) Receive of the Arbidol. This study also approximately 30 people in the group. The authors found that those who took Arbitol, the antibody titers are growing faster, but did not describe the clinically significant effects.
One study was carried out in China, it is described as a double blind (Mzwang et al. 2004). It included 232 people and the results are better described. From the abstract you can understand (the article is published in Chinese), which is included in the study, people with colds, arbidol did not help. Then out of the study, excluded everyone, who had a flu for laboratory and the remaining laboratory, and the remaining (half of the included in the study) showed effect - reducing the duration of the symptomatic period on one day.

It is well known that if we exclude from the study of unsuitable patients, the result is always better. However, imagine that the effect of the Arbitol really exists and worthy of attention. Then, in order to benefit from the arbidol, you need to have an opportunity in the clinic at the time of the appeal of a person to quickly establish what virus (and whether virus) is infected with this patient, and assign or not appoint him arbidol. Note that in recent years in Russia, and the whole world, the proportion of flu among patients with colds was mainly not higher than 20%. Therefore, the absolute majority of the buyers of the Arbidol could not benefit from him because they did not have flu. (Even if we assume that the action against flu exists).

In a letter from the producer of Arbidol, a group of famous Russian and English scientists is mentioned, which is an important step in a long and painstaking study of the drug in Russia and in leading international centers. This article really exists, but it is dedicated to the study of molecular mechanisms providing flu virus resistance to Arbidol (AntiViral Res 2009 81 (2): 132-40). Such a study cannot prove that the reception of the Arbidol helps with flu.

So, Arbidol remains a low-investment drug. If 4 RCCs were published with the arbidol, then for comparison: with a popular recently antiviral drug used successfully for the treatment of influenza, Rimantadine conducted 26 RKK, with another antiviral drug Zanamivir - 39. All about the arbitration published 38 articles in magazines indexed in MEDLINE (about Rimantadine - 658). Out of 38 in Russian - 24, another 6 - in English Russian authors, and 7 - Chinese. It turns out that for the long years of the presence of arbidol in the Russian market, researchers from abroad he really did not interest.

Now, in the event of the sustainability of the influenza virus (in different extent) to all antiviral drugs, any new anti-influenza drug attracts serious attention of the world community. The task becomes even more relevant due to the threat of epidemic spread of new virus options, because it is antiviral chemotherapy that could help in the treatment of such new diseases. Alas, for many years about the arbidol failed to get and present the world of convincing data in his favor. Those studies that we found do not give grounds to consider the arbitol as a drug with a test activity for the treatment of colds, including flu, including influenza.

If the manufacturer of the drug or someone will finally hold a benign studies that demonstrate the effectiveness of the Arbitol, the value of such a contribution of domestic pharmacists in the well-being of mankind can hardly be overestimated. In the meantime, there is no reason to spend money on this and similar drugs with unproved efficiency, because all drugs, even useless, can harm.