Many of you have been hearing about the drug Remdesivir in the fight against COVID, but just how significant is this medication? Is it helping to save lives? Is it only helpful in certain populations? Well read further as I take a dive into its most recent study and summarize key clinical points.
Remdesivir is still under investigation in clinical trials, however it has been approved for emergency use in Severe COVID-19 patients with dire need.
Severe COVID-19 is defined as having an oxygen level less than or equal to 94% on ambient air and hence requiring oxygen or mechanical ventilation (Intubation)
Patients in this study were randomized to receive Remdesivir IV or Placebo IV and the primary outcome was time to recovery. Overall, patients who received Remdesivir had a shorter time to recovery than patients in the placebo group of approximately 4 days shorter than those who did not receive Remdesivir. This result was statistically significant.
However, when looking at specific subgroups, it was interesting to see that Remdesivir was significantly beneficial in patients who were not on mechanical ventilation (intubated) and appeared to make no difference in those who were on mechanical ventilation. It also appeared to not be significant in those of Black, Asian and Hispanic descent. Furthermore, when looking at age groups, Remdesivir was significantly efficacious in the younger population within an age range of 18 to 39 years and also the elderly population starting at age 65 and older. Unfortunately, Remdesivir did not make a difference in those who were between the ages of 40 to 64.
In regards to safety, respiratory failure occurred more often in patients who did not receive Remdesivir. The most common adverse events in the Remdesivir group were anemia, acute kidney injury, decreased renal function, fever, increased blood glucose levels and increased aminotransferase or liver enzyme levels.
It is promising that Remdesivir is helping those hospitalized with severe COVID-19 to recover much faster, however further studies will be needed to ensure it can be equally beneficial across all different groups of people.
Check out a Drug Monograph I created below for Remdesivir!
| Remdesivir Monograph |
| INDICATION |
| Hospitalized patients diagnosed with severe COVID-19 (Currently under Clinical Trial) |
| DOSING |
| Day 1: 200 mg IV once over 30-120 minutes Day 2-5: 100 mg IV daily over 30-120 minutes For patients who require mechanical ventilation extend treatment duration for 10 days |
| WARNINGS |
| •Do not administer in patients with eGFR < 30 ml/min due to risk of accumulation of cyclodextrin (an excipient of the medication) •May cause liver injury hence liver transaminases must be monitored daily (discontinue if ALT >/= 5X the ULN •Risk of infusion reactions such as hypotension, shivering, nausea/vomiting |
| COMPOUNDING |
| •Allow Remdesivir to warm to room temperature before dilution into a 250 ml bag of Sodium Chloride 0.9% •Remove drug volume from Sodium Chloride 0.9% bag before injecting the drug ( 200 mg dose = 40 ml; 100 mg dose = 20 ml) |
— Ms Rx Geek