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Conflicting results on the potential effectiveness of remdesivir

There are mixed reaction on the effectiveness of the drug from two different trials . Where drugmaker Gilead Sciences announced positive early findings from a U.S., a Chinese trial have disappointing results

Gilead announced that trial run by U.S. National Institute for Allergy and Infectious Disease (NIAID) found that COVID-19 patients treated earlier with remdesivir had better outcomes than those who received the drug later in the course of their illness. The trial also will show that people who take remdesivir for five days do as well as patients who take a 10-day course.

While disappointing results emerged from from China. The first gold-standard clinical trial for remdesivir found that the drug did not help patients severe COVID-19. Those findings were published April 29 in The Lancet medical journal. During study 237 severely ill patients were randomly chosen to receive either remdesivir or a placebo between Feb. 6 and March 12 at 10 hospitals in Hubei with an aim to recruit 453 patients, but a steep decline in COVID-19 cases prevented them from reaching that goal.

According to the Chinese research team those who received remdesivir did not receive any apparent benefit over the placebo, regardless of when treatment started. Their trial found that intravenous remdesivir did not significantly improve the time to clinical improvement, mortality, or time to clearance of virus in patients with serious COVID-19 compared with placebo.

On the other hand early results reported Wednesday by Gilead are based on an initial phase of the U.S.-led clinical trial involving 397 patients with severe COVID-19 assigned to receive either 5 or 10 days of remdesivir. There was no mention of a control or placebo group.

According to Gilead, at least half of patients treated with a five-day dose of the drug improved and more than half were discharged from the hospital within two weeks. Report also added that more than 64% of the patients who received the shorter treatment course were discharged, compared with 54% of the group treated for 10 days. The trial also showed that early treatment soon after development of symptoms did better than those who got it later.

Infectious disease experts are encouraged by the result of Gilead but they are disappointed from the side of china trial.

Expert Comments.

Chinese team only enrolled half the patients you would need to have a powerful study result. It would have been great if they had seen evidence it worked, even in the small number of patients they studied. It’s not a very encouraging result, but it’s inadequate to say the drug doesn’t work. Dr. Aaron Glatt, chairman of medicine and hospital epidemiologist with Mount Sinai South Nassau in Oceanside, N.Y
Chinese trial is an important milestone and allows us to better assess the impact of the drug in a rigorous manner. The study, because it did not meet its enrollment goals, is underpowered so it is not a definitive result and will need to be supplemented with other trial data. For example, the primary end point of the NIAID-designed trial was met and will provide more information on the benefit of the drug, Dr. Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security

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