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Remdesivir- Possible COVID-19 Drug

Remdesivir- A possible drug underway to treat COVID-19

    Ever since the first case of coronavirus in Wuhan, China, the coronavirus has presented itself as a potentially fatal disease with symptoms including pneumonia, organ failure and ultimately death. According to Johns Hopkins University, the mortality rate in the U.S. due to COVID-19 is 5.4% as of April 20, 2020. Coronavirus has been spreading rapidly across the globe and taking many lives with it. Doctors and scientists have been working tirelessly these past few months looking for ways to flatten the curve and develop drugs to fight the novel coronavirus. Although none have yet been approved by the FDA, an antiviral drug originally developed against the Ebola virus shows potential to be effective against the coronavirus. The name of this drug is remdesivir.

How it works

    You may be wondering how a drug that was developed for ebola can be effective against the coronavirus. The ebola and coronavirus both have genomes made of RNA which need to be copied in order for the virus to replicate. The chemical compounds in remdesivir are similar to RNA nucleotides in the coronavirus genome. When the RNA virus for COVID-19 tries to replicate, it is tricked into including remdesivir into its genome as an anomalous letter. This indecipherable extra letter puts a stop to the replication process. Without the ability to replicate, viruses are unable to infect human cells.


Early evidence of effectiveness

    From January 25 to March 7, 2020, Gilead Sciences, a pharmaceutical company based in Foster City, CA, provided patients hospitalized with coronavirus with compassionate use of remdesivir. Their results and methods were published in the New England Journal of Medicine. Fifty-three patients received a 10-day course of remdesivir. Overall, a majority of the patients, 36 out of 53, (68%) showed improvement after being treated with remdesivir. (Grein, Jonathan, et al. “Compassionate Use of Remdesivir for Patients with Severe Covid-19: NEJM.” New England Journal of Medicine, 13 April 2020) In comparison, control groups from other studies in China where patients were given placebo (no drug), had a mortality rate that ranged from 17-78%. The Gilead study indicates that remdesivir is effective against the coronavirus with a death rate of 13%, a significantly lower number than the death rate of the control group.

Significance and other clinical trials

    Although the results from the Gilead trial seem promising, there are many caveats that don't validate the trial. For example, the trial had no controls and the participants were not randomized. The only sure way to determine if remdesivir will help humans fight against COVID-19 is through a controlled and randomized trial. However, there are many more rigorous trials now taking place with the use of remdesivir. These trials contain a larger group of patients as well as randomized control groups. The NIH, National Institute of Health, has been conducting controlled clinical trials where they have enrolled 805 patients at testing sites around the world. Their trials are still ongoing and their results have yet to be published. With organizations such as NIH conducting these trials, there is hope that remdesivir could become a potential drug against the coronavirus. To get more information on the ongoing NIH trials, go to clinicaltrials.gov (NCT0428075). Along with remdesivir, other drugs are also currently being investigated and tested against the coronavirus. With the ongoing trials, we should be able to receive definitive results soon.

Sources

  1. “Press Data on 53 Patients Treated With Investigational Antiviral Remdesivir Through the Compassionate Use Program Published in New England Journal of Medicine.” Gilead Creating Possible, 10 Apr. 2020, www.gilead.com/news-and-press/press-room/press-releases/2020/4/data-on-53-patients-treated-with-investigational-antiviral-remdesivir-through-the-compassionate-use-program-published-in-new-england-journal-of-medici.
  2. Grein, Jonathan, et al. “Compassionate Use of Remdesivir for Patients with Severe Covid-19: NEJM.” New England Journal of Medicine, 13 Apr. 2020, www.nejm.org/doi/full/10.1056/NEJMoa2007016.
  3. Collins, Francis. “Pursuing Safe and Effective Anti-Viral Drugs for COVID-19.” National Institutes of Health, U.S. Department of Health and Human Services, 17 Apr. 2020, directorsblog.nih.gov/2020/04/17/pursuing-safe-effective-anti-viral-drugs-for-covid-19/.


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