key: cord-0738886-tmlx60gw
authors: Yoo, Jin-Hong
title: Uncertainty about the Efficacy of Remdesivir on COVID-19
date: 2020-06-10
journal: J Korean Med Sci
DOI: 10.3346/jkms.2020.35.e221
sha: feb03f8222bf5937a9b0125bb2577ad57d7fdf02
doc_id: 738886
cord_uid: tmlx60gw

nan

Is the remdesivir a definitive treatment regimen for COVID-19?

Regrettably, the current assessment of remdesivir does not seem to be entirely positive.

The first full-scale clinical trial of remdesivir was conducted in China from February to March 2020, and the results were very disappointing. It did not significantly reduce COVID-19 disease duration and mortality. Moreover, a number of serious side effects occurred quite a bit, and the clinical trial had to be terminated early. 2 On the other hand, a clinical trial conducted in the United States produced relatively favorable result. 3 In remdesivir group, time to recovery was shortened compared with that of the placebo group. However, the mortality was not significantly different between the two groups.

Taken together, the results suggest that remdesivir shortens the duration of the disease, but does not affect prognosis significantly.

Then, is the remdesivir less valuable as a COVID-19 treatment?

I cannot conclude that it is.

From a practical standpoint, COVID-19 pandemic is still not suppressed, so it is inevitable to try drugs that could work.

Several drugs have been suggested, but at this point remdesivir is worth trying as a solution.

Remdesivir is undergoing clinical trials in a few medical institutions in Korea, and recently received emergency approval by the Korean Ministry of Food and Drug Safety.

Unlike the precedent of oseltamivir used during the swine flu pandemic in 2009, however, remdesivir is not expected to have the effect of lowering the rate of propagation and reducing the incidence by administering to all patients in the early stage of COVID-19 pandemic.

It should not be forgotten that remdesivir was not originally designed to target COVID-19. It is an antiviral drug originally designed to treat hepatitis C, Ebola, and Marburg virus.

Since there is no specific targeting drug to use right now, it is only a repurposed drug used on the basis of the mechanism of action. Therefore, don't expect miracles about remdesivir's performance and lower expectations.

In a word, at least now remdesivir is not a magic panacea. Even if remdesivir has a strong effect, we will need to find a partner or partners with something synergistic. Eventually, a definite antiviral treatment strategy for COVID-19 should be an appropriate and effective combination regimen.

Until the regimen is established, optimism for remdesivir should be avoided for the time being.

Current pharmacological treatments for COVID-19: What's next?

Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial

Remdesivir for the treatment of Covid-19 -preliminary report