Big global study finds remdesivir doesn't help COVID-19 patients

Marco Green
October 18, 2020

The worldwide research found no evidence that several treatments, including the promising antiviral drug remdesivir, had any real effect on patients' odds of survival or other outcomes.

There was also no significant difference in mortality for interferon-β1 (RR 1.16, 95% CI 0.96-1.39, P=0.11), nor HCQ (RR 1.19, 95% CI 0.89-1.59, P=0.23) and lopinavir (RR 1.00, 95% CI 0.79-1.25, P=0.97), both of which had previously shown no benefit in other randomized trials.

US President Donald Trump has also received remdesivir as well as dexamethasone and a cocktail of other drugs for his coronavirus infection, according to White House doctors.

"The main outcomes of mortality, initiation of ventilation and hospitalisation duration were not clearly reduced by any study drug", wrote the authors of a preliminary paper on the findings, released on the preprint website medRxiv Thursday. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, acknowledged at the time that remdesivir was not a "knockout" drug.

Commenting on the findings, Dr. Soumya Swaminathan, WHO Chief Scientist, said, "Personal experiences are valuable".

"The findings hold significance as the use of remdesivir (for restricted emergency use purposes) has been recommended for treating coronavirus patients in the moderate stage of the illness as investigational therapies" in Clinical Management Protocol for COVID-19 issued by the Union health ministry.

Two ampules of remdesivir, which was developed to treat Ebola [File: Ulrich Perrey/Pool via Reuters] The randomised trial of the drugs took place in 405 hospitals across 30 countries and involved 11,266 patients.

Earlier this month, data from a United States study of remdesivir by Gilead showed the treatment cut patients' COVID-19 recovery time by five days compared with patients who got a placebo in a trial comprised of 1,062 subjects.

The viruses that cause COVID-19, SARS and MERS have common mechanisms that might be promising targets for a treatment that would work against all three, plus future viruses, researchers reported on Wednesday in Science.

While the Solidarity data are "robust", they may not address whether certain patients are helped by the drug, said Richard Russell, a respiratory physician and senior clinical researcher in the Nuffield Department of Medicine at Oxford, who is conducting studies on Covid-19 patients.

"A major clinical breakthrough looks different and warns us that the battle against Covid-19 is far from won".

"We are concerned that the data from this open-label global trial have not undergone the rigorous review required to allow for constructive scientific discussion, particularly given the limitations of the trial design", the firm said.

But he added: "This provides more evidence that remdesivir is no panacea". The study is posted on a pre-print server and is yet to be peer-reviewed.

"This is a drug that has to be given by intravenous infusion for five to 10 days", and costs about $2,550 per treatment course, he said. "Covid affects millions of people and their families around the world. Why pay 1 billion euros for a drug with no effects on survival?" said Andrew Hill, a senior visiting research fellow in the Department of Pharmacology at the University of Liverpool. We need scalable, affordable and equitable treatments.

Other reports by Click Lancashire

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