World Health Organization defends conclusion that remdesivir is ineffective against COVID-19

Coronavirus: Remdesivir has 'little effect' on death risks, says WHO

Coronavirus: Remdesivir has 'little effect' on death risks, says WHO

In a blow to one of the few drugs being used to treat people with Covid-19, the World Health Organization said on Thursday that remdesivir appeared to have little or no effect on 28-day mortality or length of hospital stays among patients with the respiratory disease.

The UN agency hired independent statistician and epidemiologist Richard Peto to evaluate its "Solidarity Therapeutics Trial" results after U.S. biopharmaceutical company Gilead criticized the WHO's methodology, saying the trial's findings appeared inconsistent with evidence from other studies.

The trial found that overall, remdesivir did not reduce deaths and did not help patients with severe Covid-19 get out of the hospital more quickly. "Lots to learn about how they did it", medRxiv co-founder Harlan Krumholz, MD, of Yale University, tweeted about the study.

Remdesivir was approved for use in people who were sick enough to need supplemental oxygen or breathing support, as per ICMR protocol, but has now emerged as standard of care for treating hospitalised Covid-19 patients. The patients who were part of the trial were hospitalized with a diagnosis of COVID-19.

The trial admitted a broad selection of patients, resulting in heterogeneity that makes it "unclear if any conclusive findings can be drawn from the study results", the company added.

"I do think it's possible to say overall and across all patients there don't seem to be any mortality benefits for Remdesivir". They combined the four findings for a death rate ratio of 0.91 (95% CI 0.79-1.05).

The data from the ACTT-1 trial on 1,062 patients by the United States government's National Institute of Allergy and Infectious Diseases (NIAID) published in the New England Journal of Medicine (NEJM) has found that hospitalized patients with COVID-19 pneumonia who received Remdesivir recovered five days faster than patients receiving placebo at day 29, and had evidence of lower respiratory tract infection.

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In a statement, Gilead said the findings of the study were "inconsistent" with others, and that it was "concerned" that the results have yet to be reviewed. The trial stopped using hydroxychloroquine and lopinavir in June. Interferon was discontinued on October 16.

The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus. The agency made similar recommendations for HCQ and lopinavir.

The WHO's Solidarity Trial also involved the HIV treatment lopinavir/ritonavir, the malaria drug hydroxychloroquine and multiple sclerosis drug Interferon.

"The outcome of in-hospital mortality is imperfect because deaths can of course occur outside of the hospital", Spinelli said, adding that remdesivir requires participants to remain in the hospital for the 10-day treatment.

The study, conducted in 405 hospitals in 30 countries, enrolled approximately 11,266 adults, Firstpost reported.

Spinelli said it will be important to look at trials examining both remdesivir and dexamethasone to fully understand what recovery time, mortality and duration of infectiousness look like when both therapies are used together.

The remdesivir findings aren't terribly surprising based on previous findings, but they are "still impactful", especially given the dizzying size of the Solidarity trial, said Dr. Maricar Malinis, an infectious disease physician at Yale University.

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