Efficacy of Remdesivir against COVID-19

This final report published in NEJM about the efficacy of remdesivir against COVID-19 infection vs placebo showed its superiority though only in soft end points, which does not seem to modify the course of this pandemic.

Remdesivir contra el COVID-19

Multiple drugs initially promising have been shown ineffective against the new virus. The case of hydroxychloroquine resulted paradigmatic: not only was it ineffective, but also damaging. 

No antiviral agent had shown any promise so far. 

The ACTT-1 was a double-blind study, randomized and placebo controlled that tested intravenous remdesivir in adults hospitalized for COVID-19 with evidence of respiratory compromise. 

Randomization consisted of a 200 mg load of remdesivir on day 1, followed by 100 mg/day for 9 days vs. placebo for 10 days. Primary end point was time to recovery defined by hospital discharge.


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It included 1062 patients (541 receiving Remdesivir vs 521 receiving placebo).

Those in the remdesivir arm had a 10 day mean recovery time vs. 15 days in the placebo group (p<0.001).

In the different risk categories, clinical recovery was faster with remdesivir. Morality was 6.7% with remdesivir vs 11.9% at 15 days and 11.4% vs 15.2% at 29 days, respectively. 


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Adverse events were reported in 24.6% of patients receiving remdesivir vs 31.6% of the placebo group. This speaks of drug safety.

Conclusion

Remdesivir is superior to placebo in shortening recovery in patients hospitalized for COVID-19 with respiratory compromise.

Original Title: Remdesivir for the Treatment of Covid-19 — Final Report. The ACTT-1 Study Group.

Reference: J.H. Beigel et al. N Engl J Med. 2020 Oct 8;NEJMoa2007764. doi: 10.1056/NEJMoa2007764.


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