Remdesivir Shows Promise In COVID-19 Treatment

May 19, 2020

The drug Remdesivir is showing promise as a treatment for COVID-19 patients. In clinical trials, patients recovered several days sooner than patients who got a placebo, and the U.S. Food and Drug Administration approved its use several weeks ago. Remdesivir’s maker, Gilead, has released 600,000 doses in America. Michigan got almost 11,000 doses, enough to treat 1,200 patients.

To learn more about Remdesivir, WKAR’s Scott Pohl spoke with MSU infectious disease expert Dr. Peter Gulick.

SCOTT POHL: On May 1, The New York Times did a story on Remdesivir, in which it said that the drug had failed as a treatment for several diseases including Ebola. What can you tell us about the development of Remdesivir?

DR. PETER GULICK: Remdesivir was initially developed years ago, and it was looked at as a treatment for possibly COVID-1 and then also for Ebola virus. They also even looked at it for MERS, but what happened was all these small outbreaks got under control reasonably early and so they really didn't use it for any treatments for any of the three viruses. It kind of got put on the shelf. Then when CoV-2 came around, they took it off the shelf actually and started to look at it in the test tube to see if it had any activity against CoV-2, and actually it did show to have activity, and then that's what started the studies to occur.

POHL: What do we know about the side effects or the risk factors that might be involved in using Remdesivir?

DR. GULICK: Well, it has some side effects. You have to monitor liver function. It’s excreted by the kidneys, so people that have renal disease or renal failure wouldn't be a good candidate for it and you do have to watch renal function. Then, it causes some other more mild symptoms, some nausea, GI symptoms, but but most of it is pretty tolerable.

POHL: A federal trial found that Remdesivir did not significantly affect fatality rates, but patients who got the drug did recover faster than others who got a placebo. Do we know if it had a notable impact on how sick patients were?

DR. GULICK: After it was found to be effective in the test tube, Gilead actually looked at it in some non-randomized trials where they just looked at a group of patients, about 61 or 62 patients. They found that patients that got Remdesivir actually had improvement in getting off the ventilator, they improve quicker, so there was some evidence even clinically that it was effective.

The next trial was done in China, but because the numbers were so low as far as patients that were put on Remdesivir, because it was pretty much limited to people that were pretty sick in the hospital, people that were on ventilators and quite ill, and they didn't have enough patients to show that it really had any more difference than having nothing at all. That's when the NIH did the big trial where they had over 1,000 patients, and again, it was compared to somebody without any treatment, so a placebo, and what they found there was preliminarily that Remdesivir had a 31-percent faster time to recovery than somebody on the placebo, and the mortality rate was also improved on Remdesivir versus the placebo. Even though it wasn't statistically significant, it was still enough that they said okay, we want to release this drug now and start giving it to a lot of patients.