Punchline - <i>"Although not statistically significant, patients receiving remdesivir had a numerically faster time to clinical improvement than those receiving placebo among patients with symptom duration of 10 days or less (hazard ratio 1·52 [0·95–2·43])."</i><p>That said, this morning Gilead reported that in their own pivotal trial that the drug met it's primary endpoint.[1] What we don't know is how big of an effect it was.<p>[1]<a href="https://endpts.com/gilead-pivotal-covid-19-study-of-remdesivir-met-its-primary-endpoint/" rel="nofollow">https://endpts.com/gilead-pivotal-covid-19-study-of-remdesiv...</a>
Not an expert, not a doctor, etc.<p>My barely informed interpretation and resulting take here is that:<p>1) This really only shows any efficacy when given shortly after the onset of symptoms<p>2) Remdesivir is an expensive and IV only drug that is difficult to produce in high quantities<p>3) The combination of the above makes this not particularly useful for treating the general population - we do not want everyone that shows mild symptoms to be rushing to the doctor for a treatment that has to be provided by a professional, and by the time we know if the symptoms will be severe and life threatening it is too late for remdesivir to be useful<p>4) That would seem to make it most useful for people that have known risk factors and co-morbidities to be candidates for remdesivir use. I do not know if the results are similarly promising for people that have those criteria, however.<p>If these results hold up it's good news, but I don't know if it's great news - it seems like the factors involved here make it impractical for the large scale treatment of cv19
From a nurse in Wuhan who is a family friend: It seemed clear to her and her coworkers that Remdesivir was working when given early, but had little or no effect after the disease had progressed.<p>My take: sounds like great news for a product, since everyone would want this on hand to catch infections early. Unfortunately it is an IV treatment and very difficult to manufacture, and is therefore unlikely to be able to fill that role. I bought a few shares anyway.
Notwithstanding its effectiveness... I'm not sure if this could quickly be produced on a large scale.<p>For those versed in organic chemistry: looks pretty complicated. Maybe someone with industry experience can guess how difficult this is to productionize on a global scale?<p><a href="https://en.m.wikipedia.org/wiki/File:Synthesis_of_Remdesivir.png" rel="nofollow">https://en.m.wikipedia.org/wiki/File:Synthesis_of_Remdesivir...</a>
This is an older study which IIRC terminated early because they couldn’t rectuit enough ppl.<p>There is newer, positive data coming out today from the ongoing study of advanced covid: <a href="https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19" rel="nofollow">https://www.niaid.nih.gov/news-events/nih-clinical-trial-sho...</a>
I honestly do not understand what the interpretation means:<p>"In this study of adult patients admitted to hospital for severe COVID-19, remdesivir was not associated with statistically significant clinical benefits. However, the numerical reduction in time to clinical improvement in those treated earlier requires confirmation in larger studies."
It sounds like the patients in the study were a bit far into the illness already. Maybe lots of damage is already done and they are just having to additionally cope with the side-effects of the drug and not getting much of the benefit due to it having been started too late.
Nobody seems to be talking much about favipiravir, which seems a bit like not-invented-here syndrome. If it stood to make a lot of money for some US big pharma company I suspect we'd be hearing more about it.
Ok, excuse me for just complaining, but this study setup seems... bad.<p>That is, I believe the prior indication was fairly low to null that antiviral drugs would significantly help the treatment of a severe respiratory infection -- in the first place. You don't give someone Tamiflu when they have a sufficiently severe flu pneumonia and fever to be hospitalized, do you?<p>Antivirals are usually indicated for treatment when an infection is still in its early, mild, pre-hospitalization stages. I understand that it's easier to recruit study subjects with severe COVID-19 than mild at this stage, but still, doesn't this study amount to looking for one's keys under the lamp-post because it's brighter there?
Lots of legitimate questions about statistical significance, but it's strong enough that Fauci likes it[1], which tells me it can't all be bunk (given how cautious he's been about *quine):<p>> White House health advisor Dr. Anthony Fauci said Wednesday that data from a coronavirus drug trial testing Gilead Sciences’ antiviral drug remdesivir showed “quite good news” and sets a new standard of care for Covid-19 patients.<p>> Speaking to reporters from the White House, Fauci said he was told data from the trial showed a “clear cut positive effect in diminishing time to recover.”<p>[1] <a href="https://www.cnbc.com/2020/04/29/dr-anthony-fauci-says-data-from-remdesivir-coronavirus-drug-trial-shows-quite-good-news.html" rel="nofollow">https://www.cnbc.com/2020/04/29/dr-anthony-fauci-says-data-f...</a>