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Remdesivir is the first drug found to block the coronavirus – Science News

Posted: May 1, 2020 at 10:02 pm

An antiviral drug called remdesivir isthe first treatment to show efficacy against the coronavirus.

Preliminary results from a clinical trialcomparing the drug with a placebo suggest that remdesivirspeeds recovery from COVID-19 by 31 percent, the U.S. National Institute ofAllergy and Infectious Diseases said April 29 in a news release.

The international trial randomly assigned1,063 people hospitalized with COVID-19 to get intravenous infusions of eitherremdesivir or a placebo. In the remdesivir group, the median time to recoverywas 11 days, compared with 15 days for those on the placebo. Recovery wasdefined as being discharged from the hospital or being well enough to resumenormal activity. Eight percent of people in the remdesivir group died, comparedwith 11 percent in the placebo group.

Although a 31 percent improvementdoesnt seem like a knockout 100 percent, it is a very important proof ofconcept, Anthony Fauci, director of the NIAID, said April 29 during a newsbriefing at the White House. It has proven that a drug can blockthis virus.

Normally, researchers would have waitedto make the announcement until the results had been reviewed by otherscientists, but the team chose to make the announcement early, Fauci said.Whenever you have clear-cut evidence that a drug works, you have an ethicalobligation to immediately let the people who are in the placebo group know sothat they can have access.

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Remdesivir will now be the standard ofcare by which other drugs are judged, Fauci said. The trial will be adapted to addto the remdesivir treatment an antibody that may protect against inflammation,he said.

Remdesivir, developed by biopharmaceuticalcompany Gilead Sciences, headquartered in Foster City, Calif., mimics abuilding block of RNA, the coronaviruss genetic material. When the viruscopies its RNA, remdesivir is incorporated instead of the usual RNA components,stopping the viruss replication.

In studies in lab dishes and animals,remdesivir has been effective against a wide variety of RNA-containing viruses,including those that cause MERS and SARS. Its passed every single milestone.It works against every coronavirus weve tested, says Mark Denison, avirologist at Vanderbilt University Medical Center in Nashville, who was notinvolved in the study.

Remdesivir has been most effective inanimal studies when given early in infections, Denison says. The drug can stopor slow viral replication but doesnt block the bodys overzealous immunesystem responses that cause additional damage for many severely ill COVID-19patients. He likens remdesivir to a fire extinguisher. If theres a fire, andyou put it out with the fire extinguisher, youre not going to get burned. Butif you fall in [the fire] and burn your arm, you can apply the fireextinguisher and maybe youll limit the burn, but you cant heal it.

If the drug can be given early in the infection difficult to do with a drug like remdesivir that is given intravenously and must be administered by trained medical professionals then people might never become ill enough to need to go to the hospital. You [could] convert this from being a lethal disease, to being a manageable, survivable disease, Denison says.

A similar compound given as an oral drugmight even be used to prevent infections, Denison says.

Gilead also announced results of another remdesivir trial on April 29. That study compared a five-day course of remdesivir with 10 days of treatment. There was no control group that didnt get the drug. It took 10 days for half of people on the shorter course of remdesivir to have clinical improvement compared with 11 days for those in the longer-treatment group.

The study demonstrates the potentialfor some patients to be treated with a 5-day regimen, which couldsignificantly expand the number of patients who could be treated with ourcurrent supply of remdesivir. This is particularly important in the setting ofa pandemic, to help hospitals and health care workers treat more patients inurgent need of care, the company said in a news release.

Of the 200 people in the five-daytreatment group, 129 went home from the hospital by day 14, while 106 of the197 people who got the longer treatment were discharged by day 14.

Treating earlier was also beneficial. Sixty-twopercent of patients who got treatment within 10 days of their symptoms startingwere able to go home after two weeks in the hospital, but only 49 percent ofthose who got treatment later in the infection were discharged after two weeksin the hospital.

A smaller, incomplete study publishedApril 29 in the Lancet appears tocounter the results of the NIAID study. The Lancetstudy, conducted in 10 hospitals in Wuhan, China, where the pandemic firststarted, found nostatistically significant improvement in recovery time in severely illCOVID-19 patients given remdesivir, compared with those who got a placebo.

In that study, the median time torecovery for patients taking remdesivir was 21 days, compared with 23 days forthose getting a placebo. There was a trend that remdesivir sped recovery forpeople who had symptoms for less than 10 days, but that result didnt meetstatistical thresholds. That trial stopped early because Wuhans lockdowneffectively stopped transmission so that researchers werent able to recruitenough patients to fill the trials slots. As a result, the trial lacked thestatistical power to detect differences between the groups, Denison says.

Previous results from a study of patients given remdesivir for compassionate use when no clinical trial was available showed that 36 of 53 people given the drug needed less supplemental oxygen afterward, researchers reported April 10 in the New England Journal of Medicine.

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Remdesivir is the first drug found to block the coronavirus - Science News

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