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The antiviral drug remdesivir should not be used as a routine treatment for COVID-19 patients in intensive care units, the head of one of the world’s leading bodies representing intensive care physicians said in a shot at the drug developed by the company. American Gilead.
Remdesivir, also known as Veklury, and the steroid dexamethasone are the only medications licensed to treat COVID-19 patients worldwide.
But the largest study of remdesivir’s efficacy, conducted by the World Health Organization (WHO), showed on Oct.15 that it had little or no impact, contradicting previous studies.
In light of new interim data from the WHO Solidarity study, “remdesivir is now classified as a drug that you should not routinely use in COVID-19 patients,” European Society of Intensive Care Medicine (ESICM) President Jozef Kesecioglu, he said in an interview with Reuters.
Gilead disputes the results
Kesecioglu said the recommendation will be discussed in a scientific paper on COVID-19 therapies that ESICM is preparing with the Society of Critical Care Medicine, another critical care institution, which is expected to be published by January.
The first version of the paper, published in March, said there was not enough information to recommend the use of remdesivir and other antivirals in critically ill COVID-19 patients.
Gilead, who questioned the WHO findings, said in an e-mailed statement: “We are confident that frontline physicians recognize the clinical benefit of Veklury based on solid evidence from multiple randomized controlled trials. “.
ESICM represents thousands of anesthetists, respiratory physicians, nurses and other critical care professionals in over 120 countries.
Although doctors and hospitals are not obliged to follow his advice, his recommendation could curb the use of remdesivir.
At the end of October, Gilead cut its revenue forecast for 2020, citing lower-than-expected demand and difficulties in forecasting remdesivir sales.
Widely used
The drug remains, however, widely used in hospitals. It is licensed or approved for use in more than 50 countries and was one of the medicines given to US President Donald Trump when he tested positive for the coronavirus in October.
The European Union signed a billion euro ($ 1.55 billion Cdn) deal with Gilead for 500,000 remdesivir courses at 2,070 euros ($ 3,220 Cdn) each, days before Solidarity’s results.
The deal doesn’t oblige European countries to buy remdesivir, but governments decided to place large orders even after Solidarity’s results, with Germany buying a large stock in November, saying the drug was useful, mostly. at the beginning of the course of the disease.
WATCH | Remdesivir does little to help COVID-19 patients, says a WHO study:
A clinical study conducted by the World Health Organization finds that the antiviral drug remdesivir has little or no effect on length of hospital stay or mortality in COVID-19 patients. Dr Srinivas Murthy evaluates what this could mean for the treatment of the virus in the future. 2:04
Kesecioglu said insufficient data was available on when remdesivir might be effective or for which patients, leading to the decision to discourage its routine use in intensive care.
This means that doctors should only use remdesivir occasionally and not as a standard treatment for COVID-19 patients.
Due to the unclear benefits of remdesivir, the intensive care department at the University Medical Center in Utrecht, the Netherlands, where Kesecioglu works, has not used it to treat COVID-19 patients, he said.
Possible side effects
Ten months after the onset of the pandemic, a debate continues in the medical industry about which drugs are best for treating hospitalized COVID-19 patients.
Remdesivir has potential side effects on the kidneys, according to data shared by Gilead with the European Medicines Agency, which is evaluating its possible toxicity.
Arnaud Hot, chief of medicine at Edouard Herriot hospital in Lyon, France, told Reuters that some patients at his hospital had sustained kidney injuries and therefore no longer used remdesivir, except in rare cases.
Kesecioglu said the convalescent plasma, which is also experimentally administered to some COVID-19 patients despite not being approved, was not recommended by the ESICM for routine use in intensive care, as its benefits were unclear.
He said the potential side effects of convalescent plasma – the liquid part of the blood extracted from COVID-19 patients – were also unclear.
Conversely, Kesecioglu said dexamethasone was recommended for use in hospitalized patients because there was sufficient information on its efficacy.
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