Clinical Impact of Remdesivir in Moderate COVID-19 Unclear
Significant difference seen in clinical status versus usual care for five-day, but not 10-day, course
MONDAY, Aug. 24, 2020 (HealthDay News) -- Patients with moderate COVID-19 receiving a five-day course of remdesivir have a statistically significant difference in clinical status compared with usual care, according to a study published online Aug. 21 in the Journal of the American Medical Association.
Christoph D. Spinner, M.D., from the Technical University of Munich, and colleagues determined the efficacy of five or 10 days of remdesivir treatment versus standard care on clinical status on day 11 after treatment initiation. Hospitalized patients with moderate COVID-19 pneumonia were enrolled and randomly assigned to receive a 10-day course of remdesivir, a five-day course of remdesivir, or standard care (197, 199, and 200 patients, respectively).
The researchers found that the odds of a better clinical distribution on day 11 were increased for patients in the five-day remdesivir group compared with those receiving standard care (odds ratio, 1.65; 95 percent confidence interval, 1.09 to 2.48; P = 0.02). On day 11, the clinical status distribution was not significantly different between the 10-day remdesivir and standard-care groups (P = 0.18). Nine patients had died by day 28: 1, 2, and 2 percent in the five-day remdesivir, 10-day remdesivir, and standard-care groups, respectively. Compared with standard care, remdesivir-treated patients more frequently had nausea, hypokalemia, and headache.
"In aggregate, important questions remain regarding the efficacy of remdesivir," write the authors of an accompanying editorial. "It therefore seems prudent to urgently conduct further evaluations of remdesivir in large-scale randomized clinical trials designed to address the residual uncertainties and inform optimal use."
Several authors disclosed financial ties to biopharmaceutical companies, including Gilead Sciences, which manufactures remdesivir and funded the study.