According to an update published in the medical journal BMJ on Thursday, current evidence does not indicate that Remdesivir affects the risk of death from Covid-19 or the need for mechanical ventilation, among other important findings.
Dr Amish Adalja, a senior researcher at the Johns Hopkins Center for Health Security, who was not involved in WHO guidelines, said remdesivir may have received FDA approval but not a WHO recommendation due to emerging research. Studies initially showed some benefits against Covid-19, but as more data accumulates this appears to be changing.
“We’ve seen people realize that the usefulness of remsphere is marginal at best – and the only benefit we’ve been promoting is maybe it makes people better faster. But the evidence base for that is weak, not stringent, and I think that’s what we’re seeing reflected in WHO guidelines, only.” More evaluation of the existing data and more now, ”Adalja told CNN Thursday.
“ The fact that it was an antiviral that showed some benefits in some trials – but not in all of them – was enough to lead people to use it because we didn’t have the tools, but I think it will likely be replaced soon, ” Adalja added, adding that drug indications can change over time. .
“We have many FDA approved drugs for many conditions but are they always in the guidelines and are they always recommended? No, not necessarily. Not all of them. Therefore, we often purify the treatments,” Adalja said. “Would remdesivir be a drug? Maybe not much anymore.”
The World Health Organization has called on an international panel of 24 experts and four Covid-19 survivors to review the data and make recommendations. The recommendation against remdesivir was based on data from four randomized trials including 7,333 people hospitalized with Covid-19.
“The committee concluded that most patients do not prefer intravenous therapy with remdesivir due to the lack of certainty,” wrote researchers from various institutions around the world in the updated WHO guide.
The guideline says: “Any beneficial effects of remdesivir, if they are present, are likely to be small and the potential for significant harm will remain.” “They acknowledge, however, that values and preferences are likely to change, and there will be patients and clinicians choosing to use remdesivir as the evidence has not excluded the possibility of benefit.”
Peter Horby, a professor in the Department of Medicine at Oxford University who was not involved in the update, referred to the updated WHO recommendation as reasonable in a written statement on Thursday.
“Given this lack of evidence for any benefit on mortality, risk of ending up with a ventilator or time for clinical improvement, the World Health Organization (WHO) reasonably recommended that remdesivir should not be used in hospitalized patients with COVID-19, regardless of their illness,” he said. Horby, in the statement distributed by the UK-based Science Media Center.
“Remdesivir is an expensive drug that must be administered intravenously for five to 10 days, so this recommendation will save money and other healthcare resources,” Horby said. “Remdesivir has been recommended in many COVID-19 treatment guidelines, so this new analysis will require a rethinking of remdesivir’s place in COVID-19.”