The World Health Organization on Thursday recommended not using the antiviral remdesivir, a drug that has generated great interest in the treatment of Covid-19.
A panel of experts “concluded that remdesivir did not have a significant impact on mortality or other important outcomes for patients, such as: B. the need for mechanical ventilation or the time to clinical improvement, “says the W.H.O. announced. The panel published its Review in The BMJ magazine. The report did not completely rule out the drug’s use as a Covid treatment, but there was a lack of evidence to recommend its use.
Gilead Sciences, maker of Remdesivir, the trade name of which is Veklury, said in a statement that its drug “is recognized as the standard for the treatment of hospital patients with Covid-19 in guidelines from numerous credible national organizations, including the US National Institute of Health and Infectious Diseases Society of America, Japan, Great Britain and Germany. “It added that there are” several randomized controlled trials published in peer-reviewed journals that demonstrate the clinical benefits of Veklury. “
The potential benefit of remdesivir has been following for months, and particularly in the last few weeks The Food and Drug Administration approved it as the first treatment for Covid-19 in late October. A large study sponsored by the National Institutes of Health found that the drug reduced recovery time in hospitalized patients from 15 to 11 days. Two other studies considered by the Agency, sponsored by Gilead, did not include placebo controls, which are considered critical for evaluating efficacy.
President Trump was co-administered with remdesivir other treatments last month when he was hospitalized with Covid.
Since at least March, when the pandemic spread from China to Europe to the US, drug companies and researchers have been on the fly, and practicing doctors have experimented with any treatment that looks promising, including steroids. In September the W.H.O. Expert panel Highly recommended the use of steroids for patients in critical condition.
For the new analysis, the panel reviewed evidence from four studies, including one from the N.I.H. and another sponsored by the W.H.O. and recently published on a preprint server, including around 5,000 patients, the largest to date. The paper has not been peer-reviewed or published in a scientific journal.
The results of this study challenged some of the benefits previously presented in the N.I.H. Study, “said Dr. Bram Rochwerg, Associate Professor of Medicine at McMaster University in Hamilton, Ontario, and Co-Chair of the W.H.O. Panel.
Dr. Rochwerg said the panel “specifically stated in the document that the trials with remdesivir should continue and that certain populations may benefit from it”. But the drug is expensive and given intravenously, he noted. Use could redirect resources that could be used more effectively, said Dr. Rochwerg.
Remdesivir has been approved for emergency use in the US since the spring. In October, Gilead reported that it had had sales of $ 873 million so far this year.
The drug’s widespread use for Covid symptoms had some experts long before the F.D.A. approval.
“This is a perfectly reasonable decision by the W.H.O.,” wrote Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, in an email. “Remdesivir costs thousands of dollars. The largest randomized study looking at its use in Covid suggests it may not have any benefit. The one positive study was from before we used dexamethasone in serious illness,” added he added to a steroid that is commonly used in hospitals today.
Dexamethasone is a treatment that has been shown to help Covid-19 patients during certain stages of the disease.
The WHO. The expert report, known as the “living guideline,” is an initiative to continually update doctors and patients as new knowledge emerges that changes current medical practice.
“It’s a little worrying that we haven’t found much that works,” said Dr. Rochwerg. “But I hope that ongoing research will identify other drugs that will improve survival and symptoms.”