On Thursday, the World Health Organization recommended not to use the antiviral remdezivir, a drug that has aroused great interest as a treatment for Covid-19.
The expert group “concluded that remdezivir has no significant effect on mortality or other important outcomes for patients, such as the need for mechanical ventilation or time for clinical improvement,” the WHO said. The panel published its review in The BMJ magazine. The report does not rule out the use of the drug as a Covid treatment, but there is no evidence to recommend its use.
Gilead Sciences, a manufacturer of remdesivir whose trade name is Veklury, said in a statement that its drug “is recognized as a standard of care for the treatment of hospitalized patients with Covid-1
The potential usefulness of remdezivir has been the subject of debate and skepticism for months, especially in recent weeks, after 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 that the agency believes are sponsored by Gilead do not include placebo controls, which are considered critical for evaluating effectiveness.
President Trump received remdezivir along with other treatments last month when he was hospitalized with Kovid.
Since at least March, when the pandemic began to spread from China to Europe to the United States, pharmaceutical companies and researchers have been working on the move and practitioners experimenting with any treatment that looks promising, including steroids. In September, the WHO expert group strongly recommended the use of steroids for critically ill patients.
For the new analysis, the group reviewed evidence from four studies, including one conducted by the NIH and another sponsored by the WHO and recently published on the prepress server, which included about 5,000 patients, the largest to date. The article has not been reviewed or published in a scientific journal.
The results of this study “called into question some of the benefits previously seen in the NIH study,” said Dr. Bram Rohverg, an associate professor of medicine at McMaster University in Hamilton, Ontario and co-chair of the WHO panel.
Dr Rochwerg said the panel “explicitly stated in the document that attempts at remdezivir should continue and that there may be specific populations that could benefit.” But the drug is expensive and administered intravenously, he noted. Using it could divert resources that could be deployed more efficiently, Dr. Rohverg said.
Remdesivir has been authorized for emergency use since the spring in the United States, and in October Gilead announced that it had generated $ 873 million in revenue so far this year.
The widespread use of the drug for Covid’s symptoms confused some experts long before FDA approval.
“This is a perfectly appropriate WHO solution,” wrote Dr. Peter Bach, director of the Center for Health Policy and Outcomes at the Memorial Sloan Kettering Cancer Center, in an email. “Remdezivir costs thousands of dollars, the largest randomized study examining its use in Covid suggests that it may be of no use, and a positive study dates back to before we used dexamethasone for serious illness,” he added. on to a steroid that is now commonly used in hospitals.
Dexamethasone is a treatment that has been shown to help patients with Covid-19 in certain stages of the disease.
The report of the WHO expert group, called “living direction”, is an initiative for continuous updating of doctors and patients when new evidence emerges that changes current medical practice.
“It’s a little embarrassing that we still haven’t found much to work with,” Dr. Rohverg said. “But I hope that current research will identify other drugs that improve survival and symptoms.”
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