Blow to two drugs used in India to fight Covid

Grant Boone
October 17, 2020

The results of a large treatment trial for hospitalized covid-19 patients funded by the World Health Organisation offer little good news.

The World Health Organization has said that trial results show remdesivir and three other drugs administered to people infected with the novel coronavirus "have little or no effect" in terms of lowering the morality rate.

Asked for his opinion, Matthew Spinelli, MD, of University of California, San Francisco, cautioned that Solidarity involved many different settings around the world, with "heterogeneous approaches to the care of hospitalized COVID-19 patients", and thus trials done by the NIH may have more "external validity" to their guidelines.

Remdesivir is the only antiviral drug that has been authorized for treatment of Covid-19 patients in the US.

The UN health agency said remdesivir appeared to have little or no effect on keeping people alive or on the length of hospital stays among patients with the respiratory disease.

A huge trial like this one, conducted in various countries with various health care systems, can lead to inconsistent treatment protocols whose effects can be hard to analyze, he said.

On October 8, the group said it found that remdesivir helps COVID-19 patients recover more quickly and has the potential to prevent symptoms from worsening.

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Grain wastage has always been a major problem in India and amendments in the Essential Commodities Act will change this condition. The prime minister said his government has taken an integrated and holistic approach to deal with the challenge of malnutrition.

Remdesivir's maker, Gilead Sciences, said in a statement that the results were inconsistent with more rigorous studies and have not been fully reviewed or published.

Remdesivir received emergency use authorization from the U.S. Food and Drug Administration on May 1, and has since been authorized for use in several countries. Then, the authors looked at data on almost 740,000 COVID-19 patients and examined the use of drugs that work to protect these processes, asking whether patients who received them fared better - and they did, in some cases.

A senior ICMR official declined to say what implications the findings would have on India's current treatment policy that prescribes both remdesivir and hydroxychloroquine.

The hydroxychloroquine and anti-HIV studies were abandoned earlier this year, and interferon was dropped on Thursday. The trial researchers have posted their findings, which are yet to be peer-reviewed, on an online preprint archive.

"The big story is the finding that remdesivir produces no meaningful impact on survival", Martin Landray, an Oxford University professor who led other coronavirus treatment research, said in a statement. The company's joint procurement deal enables - but doesn't obligate - European countries to purchase remdesivir, according to the email.

"The unpromising overall findings from the regimens tested suffice to refute early hopes, based on smaller or non-randomized studies, that any will substantially reduce inpatient mortality, initiation of ventilation or [hospitalization] duration".

The drug costs $3,120 per treatment course for patients with private insurance in the United States. Under an agreement with the manufacturers, Gilead was entitled to see the results 10 days before the manuscript was submitted, Soumya Swaminathan, the WHO's chief scientist, said in the briefing. Almost 39 million people around the world have been diagnosed with COVID-19 and more than one million have died.

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