Remdesivir most beneficial for Covid-19 patients who require oxygen support but not ventilator, NIH study shows
Covid-19 patients who require oxygen but not ventilator support seem to benefit the most from the antiviral remdesivir, according to a study by the US National Institute of Health (NIH) recently.
Earlier this month, based on preliminary analysis on Covid-19 patients, the NIH announced that the drug appeared to speed up recovery by four days. Soon, the US Food and Drug Administration (FDA) approved Gilead's drug for emergency use. "Given there are no adequate, approved, or available alternative treatments, the known and potential benefits to treat this serious or life-threatening virus currently outweigh the known and potential risks of the drug's use," as per the FDA.
Now, the NIH has published its findings in The New England Journal of Medicine. The study makes a case for using the drug to treat hospitalized patients before they end up on a ventilator. "Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation,” the researchers wrote. The study enrolled 1,063 patients from 10 countries, including the US, Denmark, the United Kingdom, Greece, Germany, Korea, Mexico, Spain, Japan, and Singapore. Half of the participants received remdesivir while the other offer got a saline solution as a placebo.
The study suggested a faster recovery times with remdesivir. Those on the drug recovered by 11 days, as opposed to the placebo group's 15 days. “We now have solid data showing that remdesivir diminishes to a modest degree the time to recovery for people hospitalized with Covid-19,” NIAID Director Dr Anthony S Fauci, said in a statement.
Remdesivir may do a slightly better job than saline in improving survival. The number of deaths by day 14 stood at about 7% for the remdesivir group and almost 12% for the placebo group. The team, however, acknowledges that differences in survival between the two groups were not very significant. As for side-effects associated with the drug, the most common reactions were anemia, acute kidney injury. Otherwise, the incidence of adverse events was not significantly different between the remdesivir group and the placebo group, the study said.
The NIH is still awaiting data from the last of the 1,063 patients, after which the experts will have a clear picture of the drug's effects. For now, the early results support the use of remdesivir for patients who are hospitalized with Covid-19 and require oxygen therapy. Remdesivir did not dramatically bring down death rates as expected. "Given the high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient," the study read.
The NIH has kickstarted a study to evaluate the effects of remdesivir along with the rheumatoid arthritis drug named baricitinib. Because the latter is known to inactivate harmful immune reaction or inflammation, experts believe it can help Covid-19 patients too. Inflammation leads to a Covid-19 symptom: shortness of breath. “We look forward to the initiation of combination studies of remdesivir to understand whether the addition of other drugs may enhance patient outcomes,” Gilead Chief Medical Officer Merdad Parsey said in a statement.