An experimental drug called Gilead’s Remdesivir produced by Gilead Sciences gives us hope. But is it a real solution that gives us chances to finally put an end to this tremendous world-spread experience of the pandemic? Or is it just a momentary hype like many others? With the questionable safety of hydroxychloroquine (although the drug was so enthusiastically welcomed by President Donald Trump), it’s doubtful to ever call this one an appropriate drug-fighter against COVID-19. In those circumstances, with no national plan B whatsoever, Remeesivir comes into action, and its creators, slowly but surely become heroes. What can recent studies tell us about the prospective treatments for this deadly disease?
What is Remdesivir, and where does it come from?
Gilead’s Remdesivir is an antiviral medication developed by the American biopharmaceutical company Gilead Sciences. It’s being studied as a possible post-infection treatment for COVID-19. Recently, the company published an analysis in the New England Journal of Medicine tracking the responses of 53 patients with severe cases of COVID-19 to Remdesivir therapy. Patients were given the unapproved drug because no other options were available. According to the report, doctors observed clinical improvement in 36 of the 53 patients; eight got worse, and seven died. Doctors were able to take 17 of the 30 patients who were on ventilators, life-support devices that help people breathe, off the machines.
More about Remdesivir as a drug
Remdesivir is a nucleotide analog, specifically an adenosine analog, which inserts into viral RNA chains, causing their premature termination. It was created and developed as a treatment for Ebola virus disease and Marburg virus infections. Gilead Sciences subsequently discovered that Gilead’s Remdesivir had antiviral activity in vitro against multiple filo-, pneumo-, paramyxo-, and coronaviruses. In January 2020, Gilead began laboratory testing of Remdesivir against SARS-CoV-2, stating that Remdesivir was active against SARS and MERS in animal models. A small trial of Remdesivir in rhesus macaque monkeys with COVID-19 infections found that it prevents disease progression. On 21 January 2020, the Wuhan Institute of Virology applied for a Chinese “use patent” on Remdesivir, for the novel use of treating COVID-19.
Current affairs with Remdesivir
The authors of the study note that the death rate of the patients they observed — 13 percent — is lower than the death rate of 17 to 78 percent in China among people who are severely ill with COVID-19. Side effects included diarrhea, rash, renal impairment, and hypotension. Around the same time, Chinese medical researchers reported that Remdesivir seemed to have “fairly good inhibitory effects” on SARS-CoV-2, after which requests to begin clinical testing were submitted.
On 6 February 2020, a clinical trial of Gilead’s Remdesivir began in China. On 18 March 2020, the WHO announced the launch of a four-arm pragmatic clinical trial (SOLIDARITY trial) that would include one group of patients treated with Remdesivir. While a cohort study published in April 2020 saw possible improvement, determining whether or not the medication is effective is going to require a randomized controlled trial. As of April 2020, Remdesivir is viewed as the most promising treatment for COVID-19, and there are at least seven separate clinical trials underway or planned.
Limitations and concerns linked to Remdesivir
There are limitations on what conclusions can be drawn from the recent analysis. There was no randomized control group, which would have allowed to compare how patients given a placebo performed relative to those given Remdesivir. The total number of patients, spread out across the United States, Canada, Europe, and Japan, is still very small. But the authors of the study, and outside experts, have described the results as a reason to have hope. “We cannot draw definitive conclusions from these data, but the observations from this group of hospitalized patients who received Remdesivir are hopeful” – says Jonathan Grein, director of hospital epidemiology at Cedars-Sinai Medical Center in Los Angeles, in a statement from Gilead – “We look forward to the results of controlled clinical trials to potentially validate these findings”.
Eric Feigl-Ding, an epidemiologist and health economist at the Harvard T. H. Chan School of Public Health tweeted “TRIALS TRIALS TRIALS PLEASE”. Paul Goepfert, an infectious disease specialist at the University of Alabama at Birmingham, claims that “it’s a promising drug, but it doesn’t definitively prove anything. […] The main thing you can gather from this study is that it doesn’t cause any untoward harm”.