WHO Says No to Remdesivir as COVID-19 Treatment
FRIDAY, Nov. 20, 2020 (HealthDay News) -- The antiviral drug remdesivir is not recommended for hospitalized COVID-19 patients because there's no evidence that it reduces their need for ventilation or improves their chances of survival, a World Health Organization panel said Thursday.
Remdesivir is regarded as a potential treatment for severe COVID-19 and is used to treat hospitalized patients, but there is uncertainty about its effectiveness. Nevertheless, the U.S. Food and Drug Administration approved the drug to treat hospitalized COVID-19 patients in October.
In the new assessment, the WHO panel of experts analyzed data from four international randomized trials that assessed several treatments for COVID-19 and included more than 7,000 hospitalized COVID-19 patients.
The panel -- which included four people who've had COVID-19 -- concluded that remdesivir has no meaningful impact on the risk of death or any other important patient outcomes, such as the need for mechanical ventilation or how long it takes for their condition to improve.
The results of the trials don't prove that remdesivir has no benefit. Instead, they provide no evidence that the drug improves patient outcomes, the panel explained in an article published Nov. 19 in the BMJ medical journal.
However, given the risk of significant harm, the relatively high cost, and the demands on health care staff (remdesivir must be given intravenously), their recommendation is appropriate, the panel said.
The panel also said they support continued enrollment into trials evaluating the use of remdesivir in COVID-19 patients, especially to provide more reliable evidence for specific groups of patients.
The future use of remdesivir in treating COVID-19 patients is unclear, given that it's unlikely to be the lifesaving drug many have hoped for, American journalist Jeremy Hsu wrote in a linked article in the journal.
He also noted that alternative treatments -- such as the inexpensive and widely available corticosteroid dexamethasone, which has been shown to reduce death risk in severely ill COVID-19 patients -- are now part of the discussions about remdesivir's worth as a COVID-19 treatment.
"It's become clear that remdesivir, at best, has a marginal benefit if any on clinical improvement," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. "It is not surprising, therefore, that the WHO guideline committee does not support its use, underscoring the need for better treatments that more meaningfully impact patient outcomes."
For more on treatments for severe COVID-19, go to the U.S. Centers for Disease Control and Prevention.
SOURCES: BMJ, news release, Nov. 19, 2020; Amesh Adalja, MD, senior scholar, Johns Hopkins Center for Health Security, Baltimore
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