NIH researchers have reported that recovery time for adults hospitalized with COVID-19 with lower respiratory tract infection is shorter with remdesivir than placebo from their study published online in the New England Journal of Medicine.

However, given high mortality despite the use of remdesivir, they have warned that treatment with an antiviral drug alone is not likely to be sufficient.

John H. Beigel, M.D., from the National Institutes of Health in Bethesda, Maryland, and colleagues conducted a double-blind, randomized, placebo-controlled trial of intravenous remdesivir in 1,063 adults hospitalized with COVID-19 with lower respiratory tract involvement.

Patients were randomly assigned to receive remdesivir (200 mg loading dose on day 1; 100 mg daily for up to nine additional days) or placebo for up to 10 days.

On the basis of findings that showed shortened time to recovery in the remdesivir group, the data and safety monitoring board recommended early unblinding of results. The researchers found that based on preliminary results from 1,059 patients (538 randomly assigned to remdesivir and 521 to placebo), those who received remdesivir versus placebo had a median recovery time of 11 versus 15 days (rate ratio for recovery, 1.32; 95 percent confidence interval, 1.12 to 1.55; P < 0.001).

The Kaplan-Meier estimates of mortality by 14 days were 7.1 and 11.9 percent with remdesivir and placebo, respectively (hazard ratio for death, 0.70; 95 percent confidence interval, 0.47 to 1.04). Serious adverse events were reported for 21.1 and 27.0 percent of patients in the remdesivir and placebo groups, respectively.

“These preliminary findings,’ the authors report, “support the use of remdesivir for patients who are hospitalized with Covid-19 and require supplemental oxygen therapy.

“However, given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient. Future strategies should evaluate antiviral agents in combination with other therapeutic approaches or combinations of antiviral agents to continue to improve patient outcomes in Covid-19.”

SOURCE: https://www.practiceupdate.com/c/101269/2/20/?elsca1=emc_enews_daily-digest&elsca2=email&elsca3=practiceupdate_rm&elsca4=respiratorymedicine&elsca5=newsletter&rid=NTU2MjE4MTIzNzES1&lid=10332481

REFERENCE: Beigal et al: Remdesivir for the Treatment of Covid-19 — Preliminary Report;  https://www.nejm.org/doi/full/10.1056/NEJMoa2007764