World’s top intensive care body advises against use of remdesivir for sickest

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The antiviral drug remdesivir should not be used as a routine treatment for COVID-19 patients in critical care wards, the head of one of the world’s top bodies representing intensive care doctors said, in a blow to the drug developed by U.S. firm Gilead.

Remdesivir, also known as Veklury, and the steroid dexamethasone are the only drugs authorized to treat COVID-19 patients across the world.

But the largest study on remdesivir’s efficacy, run by the World Health Organization (WHO), showed on Oct. 15 that it had little or no impact, contradicting previous trials.

In light of the new interim data from the WHO’s Solidarity trial, “remdesivir is now classified as a drug you should not use routinely in COVID-19 patients,” the president of the European Society of Intensive Care Medicine (ESICM), Jozef Kesecioglu, said in an interview with Reuters.

Gilead contests findings

Kesecioglu said the recommendation would be discussed in a scientific paper on COVID-19 therapies that ESICM is preparing with the Society of Critical Care Medicine, another intensive care body, expected to be published by January.

The first version of the paper, released in March, said there was not enough information to recommend the use of remdesivir and other antivirals in critically ill COVID-19 patients.

Gilead, which has questioned the WHO’s findings, said in an emailed statement: “We are confident that doctors on the front lines recognize the clinical benefit of Veklury based on robust evidence from multiple randomized, controlled studies.”

ESICM represents thousands of anesthesiologists, respiratory physicians, nurses and other critical care professionals in more than 120 countries.

While doctors and hospitals are not obliged to follow its advice, its recommendation could curb the use of remdesivir.

At the end of October, Gilead cut its 2020 revenue forecast, citing lower-than-expected demand and difficulty in predicting sales of remdesivir.

Widely used

The drug remains, however, widely used in hospitals. It is authorized or approved for use in more than 50 countries and was one of the medicines administered to U.S. President Donald Trump when he tested positive for coronavirus in October.

The European Union signed a one billion euro ($1.55 billion Cdn) deal with Gilead for 500,000 courses of remdesivir at 2,070 euros ($3,220 Cdn) each, days before the Solidarity results.

The deal does not oblige European countries to buy remdesivir, but governments decided to place large orders even after the Solidarity results, with Germany buying a big stock in November, saying the drug was useful, especially early in the course of the disease.

WATCH | Remdesivir does little to help COVID-19 patients, WHO study says:

A clinical trial by the World Health Organization finds that antiviral medication remdesivir has little or no effect on length of hospital stay or mortality in COVID-19 patients. Dr. Srinivas Murthy weighs in on what this could mean for treating the…



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