It's not a cure, but remdesivir appears to help coronavirus patients recover more quickly.

By Claire Gillespie
April 30, 2020
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The nation's leading infectious disease expert has announced that the antiviral drug remdesivir, which was originally developed by US-based drugmaker Gilead to treat Ebola, can “block” COVID-19. 

In an interview with NBC News Today on April 29, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), said remdesivir “has a clear-cut, significant, positive effect in diminishing the time to recovery.” He revealed that in a large international study, patients who took remdesivir needed an average of 11 days to recover from COVID-19, compared to 15 days for those in the study who received a placebo. 

"Although a 31% improvement doesn't seem like a knockout 100%, it is a very important proof of concept," said Dr. Fauci. "What it has proven is that a drug can block this virus." 

Remdesivir is one of four treatments being studied in the World Health Organization’s “Solidarity” trial, which began in February. Dr. Fauci told NBC News Today that the “primary endpoint of the study was the patients’ time to recover, and specifically their “ability to be discharged” from the hospital. 

As well as a quicker recovery rate, the fatality rate was more favorable in the remdesivir group—8% of patients died, compared to 11% in the placebo group. 

In an earlier study involving patients with severe cases of COVID-19 in hospitals in Hubei, China, the drug didn’t accelerate recovery or reduce deaths compared to a placebo. However, that study was stopped early because not enough people could be recruited as the epidemic tailed off in China. In a statement, Gilead said the termination of the trial didn’t mean it was a failure, simply that the results were inconclusive, reported Clinical Trials Arena. On April 29, a few hours after Dr. Fauci’s announcement, the full study from China was published in The Lancet.  

More trials of remdesivir are ongoing, but in the meantime, the medical community has welcomed what appears to be a glimmer of hope for COVID-19 patients.   

“It’s an exciting development to have a therapy that may be the first approved treatment for COVID-19,” Ryan Steele, DO, an assistant professor of clinical medicine in rheumatology, allergy, and immunology at Yale School of Medicine, tells Health. “Although all the data has not been seen by the broader medical community yet, we are headed in the right direction.”

It will be some time before we know if remdesivir is a true game changer in the fight against COVID-19, Linda Anegawa, MD, an internist with virtual primary care platform PlushCare, tells Health. She points out that the study lacks statistical significance—meaning there is a likelihood that these numbers came about just by chance, rather than by a true clinical effect. 

“We will need a much larger study to be done in order to determine this,” says Dr. Anegawa. “Many patients in the study who participated didn’t seem to be all that ill, so they may have recovered naturally on their own regardless of whether they received the drug. In addition, we don’t know if the drug could have harmed patients or caused some of the adverse outcomes that were reported (such as kidney or liver failure). This is because the study lacked what is known as a control group—a group of similar patients who did not receive remdesivir, to compare with the treatment group.”

When the full, detailed data about the patients, how sick they were, and any potential side effects is released, it will be easier to evaluate the results of the trial. Hopefully, we shouldn’t have long to wait. In the NBC News Today interview, Dr. Fauci said this data is expected to be released within days.

In the meantime, the Food and Drug Administration (FDA) is moving quickly to review all available data. In a statement to CNN, FDA spokesman Michael Felberaum said the agency had been engaged in discussions with Gilead “regarding making remdesivir available to patients as quickly as possible, as appropriate." A senior administration official at the FDA told The New York Times that the agency was likely at some point to announce an emergency approval for remdesivir. 

While this isn’t the same as a formal approval, it would give Gilead permission to sell remdesivir during the COVID-19 crisis, making it available to patients who aren’t enrolled in a clinical trial. According to a statement on the company’s website, they have a large enough supply of the drug to treat 140,000 patients and intend to ramp up to a million courses of treatment by the end of 2020. 

“The bottom line is, testing antiviral medications such as remdesivir is a great start to potentially investigating multiple different antivirals and antiviral combinations in the fight against COVID-19,” says Dr. Anegawa. “But there is still much that we don't know, and this reinforces my belief that we are still far away from having a Tamiflu-like agent that could be made widely available to patients."

Dr. Steele believes that as the months progress, remdesivir will be only one of a list of recommended and approved therapies for COVID-19. “This will be critical to handling current and future spikes of cases,” he says. “Ultimately, we need long-term strategies to continue to live and work while we try to develop a vaccine for widespread use."

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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