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Remdesivir doesn’t reduce COVID-19 deaths, a large WHO trial finds | Science News 11/5/20, 2:26 PMhttps://www.sciencenews.org/article/covid-19-coronavirus-remdesivir-who-hydroxychloroquine-interferon-lopinavir-solidarity Page 1 of 3NEWS HEALTH & MEDICINERemdesivir doesn’t reduceCOVID-19 deaths, a largeWHO trial findsAn international study found no benefit of the drug or three othersIn a large international study, remdesivir, an antiviral drug, didn’t reduce the risk of death for severely ill people hospitalized with COVID-19.DIGICOMPHOTO/ISTOCK/GETTY IMAGES PLUSBy Tina Hesman SaeyOCTOBER 16, 2020 AT 5:59 PMRemdesivir, an antiviral drug that was the first found to combat COVID-19,doesn’t reduce deaths from the disease, a large international study found.The World Health Organization’s Solidarity trial, which combined data from 405hospitals in 30 countries, randomly assigned more than 11,000 peoplehospitalized with COVID-19 to receive one of four drugs or standard care,which could include other drugs such as steroids. The tested drugs includeremdesivir, the antimalaria drug hydroxychloroquine, an anti-HIV drug calledlopinavir and interferon-beta1a. Interferon is an immune system chemical thattriggers the body’s antiviral defenses.None of the drugs showed any benefit in reducing deaths, the need forventilation or the length of hospital stays, researchers report October 15 in aINDEPENDENT JOURNALISM SINCE 1921Remdesivir doesn’t reduce COVID-19 deaths, a large WHO trial finds | Science News 11/5/20, 2:26 PMhttps://www.sciencenews.org/article/covid-19-coronavirus-remdesivir-who-hydroxychloroquine-interferon-lopinavir-solidarity Page 2 of 3preliminary study posted at medRxiv.org. The work has not been vetted byother scientists yet, and some analyses may change during the peer-reviewprocess, experts say.Other studies had already shown that neither lopinavir — given in combinationwith ritonavir, a drug that boosts lopinavir’s levels in the body — norhydroxychloroquine were effective against the novel coronavirus (SN: 3/19/20;SN: 8/2/20). These studies, in addition to the new data, deliver a clear messagethat those drugs are not helpful for treating COVID-19, says David Brett-Major,a medical epidemiologist at the University of Nebraska Medical Center inOmaha.But remdesivir has been shown to shave four daysoff of hospital stays in a trial conducted by the U.S.National Institute of Allergy and Infectious Diseases(SN: 4/29/20). In that study, the drug “showed atrend toward reducing deaths,” but the result wasn’tstatistically meaningful. Preliminary results from small studies conducted byremdesivir’s maker, Gilead Sciences of Foster City, Calif., also suggested thatdrug might cut the chance of dying from the disease (SN: 7/13/20).The drug currently has emergency authorization from the U.S. Food and DrugAdministration for use in all hospitalized patients.In the WHO study, 301 of 2,743 people hospitalized with COVID-19 takingremdesivir died, compared with 303 of 2,7

08 people in the group gettingstandard care. That result indicates that remdesivir doesn’t have a mortalitybenefit, says Helen Boucher, chief of infectious diseases at Tufts Medical Centerin Boston.But that doesn’t mean remdesivir isn’t helpful, she says. Shortening hospitalstays is the reason remdesivir has been embraced, at least in the United States,Boucher says. The new WHO study aside, “the data we have now suggests it’s afour-day benefit, 11 days versus 15 days” with a placebo, she says. “That’ssignificant for people who are sick in the hospital.”“I’m very comfortable as a physician recommending this medicine based on thedata showing a shorter time to be better,” Boucher says.Although the new WHO study found that remdesivirdoesn’t reduce length of hospital stays, the trial wasdesigned to show only whether the drugs couldreduce the risk of dying. So its conclusions about whether remdesivir shortenshospital stays or cuts the risk of going on a ventilator need a closer look,Brett-Major says.That’s also in part because the WHO study combined data from hundreds ofhospitals in 30 countries. A closer analysis of data from individual study sitesSign up for e-mail updates onthe latest coronavirus newsand researchSee all our coverage of thecoronavirus outbreakRemdesivir doesn’t reduce COVID-19 deaths, a large WHO trial finds | Science News 11/5/20, 2:26 PMhttps://www.sciencenews.org/article/covid-19-coronavirus-remdesivir-who-hydroxychloroquine-interferon-lopinavir-solidarity Page 3 of 3may show a clearer picture of how remdesivir performed in different settings.Hospitalization time and whether someone is put on a ventilator may alsodepend on other factors, such as how many hospital beds or ventilators areavailable. Remdesivir may still improve outcomes for individual patients in theright circumstances, Brett-Major says.In the short term, the new study probably won’t change how remdesivir is used,says Joanne Turner, an immunologist and vice president for research at theTexas Biomedical Research Institute in San Antonio. But as more studies aredone, “we’ll get clarity on when it should be used,” she says.Many hospitalized patients, for example, are suffering more from overexuberantimmune systems trying to fight off the virus. By that time, it may be too late fora drug that prevents viral replication like remdesivir to make a difference. In theWHO study, “if the drug did stop viral replication [for patients], it clearly wasn’tchanging outcomes for them,” Turner says. “This will make doctors think aboutwhether this drug is really useful in very sick people.”But giving remdesivir to sick people earlier might help, experts say. Boucher andcolleagues are part of a study testing the drug in people who are newlydiagnosed with COVID-19 to see if can prevent hospitalization and severedisease.CITATIONSH. Pan et al. Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results. medRxiv.org.October 15, 2020. doi: 10.1101/2020.10.15.20209817