Experimental coronavirus treatment remdesivir shows promise

Two thirds of seriously ill Covid-19 patients saw their condition improve after receiving the experimental drug remdesivir, according to a study sponsored by its developer Gilead Sciences.
The drug was originally developed to treat diseases such as Ebola and has since been found to have antiviral qualities.

In a study published in the New England Journal of Medicine on Saturday, Gilead Science said clinical trials had been carried out among 53 patients.

“We cannot draw definitive conclusions from these data,” said Jonathan D Grein, director of hospital epidemiology at Cedars-Sinai Medical Centre in Los Angeles, and the lead author on the study. “But the observations from this group of hospitalised patients who received remdesivir are hopeful.”

Of these patients, 22 were in the United States, 22 in Europe or Canada and nine in Japan. They received 200mg injection of remdesivir on the first day, followed by 100mg daily for the remaining nine days of treatment.

Researchers said during a median follow-up period of 18 days, 36 patients on oxygen support had improved, including 17 out of 30 patients who were receiving mechanical ventilation. A total of 25 patients were discharged.

Seven patients died and one’s condition got worse. They included six out of 34 patients receiving invasive ventilation and one out of 19 who have not received invasive ventilation.

The study showed that 32 patients reported adverse events while the most common adverse events were increased hepatic enzymes, diarrhoea, rashes, renal impairment and hypotension.

These adverse events were in general more common in patients receiving invasive ventilation. Twelve of them had serious adverse symptoms, which included multiple-organ-dysfunction syndrome, septic shock, acute kidney injury and hypotension.

Researchers admit the limits of the study because of the small size of the cohort and the relatively short follow-up period.

Remdesivir has not been approved for market sale in any country.

Gilead Sciences said it runs two phase three studies in areas with a high prevalence of Covid-19 in the United States, Asia and Europe, aiming to answer whether treatment duration can be shortened from 10 days to five days.

In an open letter on Saturday, the company said seven clinical trials have been launched around the world to determine whether remdesivir is a safe and effective treatment for Covid-19.

“Remdesivir seems to play a role in clinical improvements. But the lack of comparisons with placebo or no-medicine groups make it hard to assess its effectiveness. There is also no important virology indication like viral load and viral shedding duration here,” he said.

But he said he was cautiously optimistic about remdesivir and looked forward to the result from future double-blind trials.
The first two trials took place in early February in 10 hospitals in China’s Wuhan, where the country’s epidemic cases were first recorded. The experiments were for patients with severe and moderate symptoms of the disease.