Just one month after the makers of remdesivir announced US Food and Drug Administration approval of remdesivir for treatment of coronavirus infection the World Health Organization updated its guidance on COVID-19 medications to recommend against using the antiviral drug remdesivir for treating hospitalized patients, regardless of the severity of the illness. This was decision was made based on current evidence that does not suggest that Remdesivir alters the risk of mortality from COVID-19, the risk of ventilation, or other important outcomes.
Remdesivir is an "intravenous nucleotide prodrug of an adenosine analog which binds to the viral RNA-dependent RNA polymerase, inhibiting viral replication through premature termination of RNA transcription." It has demonstrated in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but did not appear to be as successful in clinical trials.
While Remdesivir received FDA approval, it did not receive WHO’s recommendation due to emerging research which at first demonstrated some benefit against COVID-19, but “as more data accumulate, that appears to be changing” according to Dr. Adalja, senior scholar at Johns Hopkins Center for Health Security. Dr. Adalja shared that the benefit of “remdesivir is marginal at best” and the “only benefit we had been touting was maybe it gets people better quicker but the evidence base for this is weak.”
Based on data from four randomized trials including 7,333 people hospitalized with Covid-19, it was ultimately decided by the WHO to recommend against remdesivir as the “panel concluded that most patients would not prefer intravenous treatment with remdesivir given the low certainty evidence.”
- Claire Hillier, Nov. 20
References:
Jacqueline Howard. “WHO recommends against use of remdesivir for treatment of Covid-19” CNN. https://www.cnn.com/world/live-news/coronavirus-pandemic-11-19-20-intl/h_5890bce2fe969482f9aee583fbbd6ac3
“Remdesivir.” National Institutes of Health, U.S. Department of Health and Human Services, www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/.
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