Early Remdesivir Data

3,827 Views | 15 Replies | Last: 5 yr ago by SkiMo
Diyala Nick
How long do you want to ignore this user?
AG


Not a RCT, but mortality at only 18% for intubated patients seems like a great sign.
Marcus Aurelius
How long do you want to ignore this user?
AG
Imagine combined with toci. Think this combo plus the vaccine is the solution.
Player To Be Named Later
How long do you want to ignore this user?
AG
Are you also seeing hopeful results out of Remdesivir and Toci?
RandyAg98
How long do you want to ignore this user?
AG
Marcus Aurelius said:

Imagine combined with toci. Think this combo plus the vaccine is the solution.
Sure sounds promising from the outside.
Diyala Nick
How long do you want to ignore this user?
AG
Exciting. I would imagine there is some concern about how much production can be scaled in the next few months with both Remdisivir or anything ending in "ab".
McInnis 03
How long do you want to ignore this user?
AG
Correct me if I'm wrong, but isn't remdisivir violent on the liver?

I'm thinking avigan can probably hang with remdi and I haven't heard that it's as dangerous?
Marcus Aurelius
How long do you want to ignore this user?
AG
FWIW. Gilead/remdisivir has been much tighter / difficult to obtain drug for compassionate use c/w Genentech/Toci.
Dr. Not Yet Dr. Ag
How long do you want to ignore this user?
Uncontrolled data is difficult to interpret given numerous confounding variables and limitations of the study parameters. Did the 8 patients lost to follow up die? Are the several patients that still haven't been discharged from the hospital in the study going to definitively survive? Did they just happen to pick a group that had better odds of survival? Without randomized control groups it is difficult to say.

Unfortunately there appear to also be some issues with Gilead's RCT for remdesivir. It appears that after interim analysis they decided mid study to increase the N from 400 to 2400 and change their primary outcomes which is a bit questionable, but potentially indicates that treatment effect is much less than what was expected. There are legitimate reasons to change primary outcome and number of patients mid-trial, but given that pharma companies are for profit and we are in the middle of a pandemic and are needing answers quickly, I have a hard time believing this was done for any other reason than because they didn't expect a positive outcome with their current study design, so increased N, added additional treatment arms, and picked a softer target in order to pick up smaller treatment effect and have better powered sub group analysis which might soften the blow of a negative trial if sub group analysis demonstrates potential populations that might benefit.

I'm hoping we find something, and fast, but I am just not convinced that any of these repurposed drugs are going to be significantly effective in preventing death or significant morbidity. There is just such a long list of failed or minimally effective anti-virals, that it is hard not to be a bit pessimistic. Nevertheless, I would be happy to be proven wrong, and I think until we have more definitive data to say it does/doesn't work, we should keep it as an option in our sickest patients.

EDIT: Completely missed that they excluded any patients that died within 24 hours of treatment initiation which is incredibly sketchy and leads to what is called survivorship bias.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Infection_Ag11
How long do you want to ignore this user?
AG
There's no control group and they excluded patients who died with 24 hours of getting the drug. All you can take from this study is some people got remdesivir and some got better while others didn't.

It's clinically meaningless and wound never get published in a journal of that quality in normal times.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
gunan01
How long do you want to ignore this user?
AG
https://www.marketwatch.com/story/gilead-science-reports-positive-data-in-trial-of-remdesivir-as-treatment-for-covid-19-2020-04-29

Quote:

Gilead Sciences Inc. said that its experimental COVID-19 therapy remdesivir met the main goal in a government-funded clinical trial and that a shorter dosing regimen was as successful as a longer one in a separate study.

The early findings set the stage for the closely watched drug to move toward a possible emergency use authorization or approval from the U.S. Food and Drug Administration. The drug is currently being used on an expanded use or compassionate use basis.
gunan01
How long do you want to ignore this user?
AG
$30,000 Millionaire
How long do you want to ignore this user?
AG


Not a silver bullet like people are reacting to, but a very positive development. a 30% reduction in mortality and a 25% reduction in treatment duration is great news for hospital capacity. That said, it does not diminish the need for vigilance and there could be problems with production and availability.
corleoneAg99
How long do you want to ignore this user?
AG
So...it's not clinically meaningless?


Windy City Ag
How long do you want to ignore this user?
AG
Seems to be getting the Fauci seal of approval although there are plenty of caveats about results from the full trial.

https://abcnews.go.com/Politics/trump-fauci-tout-good-news-remdesivir-drug-trial/story?id=70407208


Quote:

Infectious disease expert Dr. Anthony Fauci on Wednesday touted the results of trial examining an experimental drug treatment for the novel coronavirus, calling it "good news" as he spoke in the Oval Office alongside President Donald Trump.

A randomized, international trial of the drug remdesivir had resulted in "quite good news," shortening the period patients experienced symptoms and potentially slightly reducing the mortality rate, according to Fauci, a member of the White House's coronavirus task force and the director of the National Institute of Allergy and Infectious Diseases, which sponsored the trial.

"What it has proven is that a drug can block this virus," Fauci said, calling the development "very optimistic."

Fauci said the data so far showed the drug, made by the biotech company Gilead Sciences, had "a clear-cut, significant positive effect in diminishing the time to recovery."

For those who took the drug, Fauci said, it took less time to recover, averaging 11 days compared to 15 days for those in a control group who received a placebo.

Fauci said the data represented "a very important proof of concept" -- showing that a drug could, in fact, "block" COVID-19.

He also said the mortality rate trended lower for those who took the drug -- 8% compared to 11% for those who did not -- although he noted that trend was not yet statistically significant, and the results will undergo further analysis.


SkiMo
How long do you want to ignore this user?
AG
I swear a few days ago that they had suspended the study of this drug. Did they start it back up?
slacker00
How long do you want to ignore this user?
AG
Same drug different study. That was one in China that stopped because there were no new patients to enroll.
SkiMo
How long do you want to ignore this user?
AG
slacker00 said:

Same drug different study. That was one in China that stopped because there were no new patients to enroll.
Oh good. I was disappointed thinking the whole thing was scrapped. Good news!
Refresh
Page 1 of 1
 
×
subscribe Verify your student status
See Subscription Benefits
Trial only available to users who have never subscribed or participated in a previous trial.