Two results came out today on Remdesivir treatment for #COVID19 infection.
The first one is a double blind controlled multi center clinical trial on 237 patients in China
The second one 5 versus 10 days treatment in severe #COVID19 patients
Let's have a look -> thread
The first study is a double blind placebo controlled multi center clinical trial in China in 237 #COVID19 patients. We have now the published result of this trial. Please remember there was a leak on this trial a week ago
158 remdesivi treatment placebo group 79 not 1:1 randomized
incl criteria > 18 y/o #SARSCoV2 + Sao2<94% pneumonia
excl criteria: pregnancy, liver enzymes high...
regimen 200 mg day 1 + 100 mg on days 2–10 IV 1x/day
outcome: clinical improvement aka discharge or ICU admission
Results. Not much difference between the 2 group. In fact results were identical between group for clinical improvement, mortality at day 28, viral load very much no differences at all.
In short no efficacy for remdesivir in this small group of #COVID19 patients
The paper has been published in @TheLancet today but unfortunately under #paywall and I don't know why. It should be one access in my view
thelancet.com/journals/lance…
So now that announcement from the @NIH today. This is again a phase 3 randomized double blind controlled clinical trial. This is the american arm of the large ramdesivir trial. This is a press release and there are very little details
niaid.nih.gov/news-events/ni…
@NIH All we know is the time to recovery is significantly lower in #remdesivir group (11 days) versus placebo (15 days) and mortality rate is lower in remdesivir group (8%) vs placebo (11%)
In my view the difference in outcome seems rather modest but more details to come soon
Next the last study, this time Gilead released the results in their press release. This is a 5 day versus 10 days open label treatment in a cohort of 397 patients. No controls included.
gilead.com/news-and-press…
They found no differences in outcome between #remdesivir 5 days versus 10 days treatment and >50% of the patients were discharged at day 14 but I don't know what all of this means without a control group. All it says is no ≠ in outcome on 5d vs 10 d treatment. That's all
In short
Remdesivir might improve clinical outcome in severe #COVID19 patients but in my view clearly not a silver bullet
More details are needed from the @NIH trial. Beware the overhype
I am concerned that many Remdesivir trials don't have a control group.Waste of resources
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