Is remdevisir the wonder drug?

By Modesto P. Sa-onoy

 

Let us deal with this question only briefly because tomorrow I will digress on an article related to the pandemic with catastrophic implications to our survival as free people.

The news last week said that the US Federal Drug Agency had approved Remdesivir for treatment of Covid-19. However, there are misgivings about its effectiveness, aside from its hefty price. An official statement of the National Institutes of Health of October 22 that precipitated the FDA approval said “Remdesivir alone isn’t a sufficient treatment for all patients but does provide some benefit. Studies are underway to evaluate Remdesivir in combination with other therapies.”

Remdesivir works primarily by preventing the virus from multiplying but not killing it.

The statement further said that “researchers began a randomized, controlled trial of the antiviral in February 2020 to test whether Remdesivir could be used to treat SARS-CoV-2, the coronavirus that causes COVID-19. By April, early results indicated that Remdesivir accelerated recovery for hospitalized patients with severe COVID-19. It became the first drug to receive emergency use authorization from the U.S. Food and Drug Administration (FDA) to treat people hospitalized with COVID-19.”

The trial was completed and the final report appeared in the New England Journal of Medicine on October 8, 2020.

According to reports issued by its manufacturer, Gilead, “The final results showed that the antiviral treatment was beneficial, consistent with the preliminary findings. Patients who received Remdesivir were quicker to recover, which was defined as being medically stable enough to be discharged from the hospital. The median recovery time was 10 days with Remdesivir compared to 15 days for the placebo group. Patients given Remdesivir were more likely to have improved by day 15.”

It does not show that Remdesivir is the fast, immediate cure-all against Covid-19. It needs a “high level of respiratory support” and “prevents patients from progressing to more severe respiratory disease.” It is also beneficial as “it may help conserve scarce health care resources, such as ventilators, during this pandemic.”

Thus, to reiterate, the “findings show that Remdesivir alone isn’t a sufficient treatment for all patients.”

The drug is not for all patients as many had hoped. The official statement by Gilead on October 22, said Remdesivir or its approved trade name Veklury was given a new Emergency Use Authorization “to treat hospitalized pediatric patients under 12 years of age weighing at least 3.5 kg or hospitalized pediatric patients weighing 3.5 kg to less than 40 kg with suspected or laboratory-confirmed COVID-19 for whom the use of an intravenous (IV) agent is clinically appropriate. This authorization is temporary and may be revoked, and does not take the place of the formal submission, review and approval process for the use of Veklury in this patient population. The use of Veklury in pediatric patients under 12 years of age or weighing less than 40 kg has not been approved by FDA, and the safety and efficacy of Veklury for this use has not been established.”

There are therefore limitations. Remdesivir is not the wonder drug. In cases where it is used for adults, the patients have to be hospitalized because the drug is administered intravenously. In fact, when the news of its approval by FDA came out, Dr. Anthony Fauci advised that people should wait for the vaccine that may yet come. However, was that a signal to shoot Remdesivir down? It seems so because the initial enthusiasm for this drug died down as fast as the printer’s ink dried.

I received a report, belatedly however, about the case in Turkey, “a country with a remarkable therapeutic response to COVID-19, and using hydroxychloroquine early and on an outpatient basis. The Sky News’ story by Alex Crawford covered the “therapeutic approach, which relies on hydroxychloroquine as a first step to treat symptomatic patients. The approach is at odds with most countries where symptomatic patients are asked to stay home, wait, until the symptoms essentially become unbearable, and then serious complications and hospitalization become very likely.”

In Turkey “as soon as patients have symptoms, they are treated with hydroxychloroquine tablets and/or favipiravir at home. Follow-up calls quickly spot if the symptoms worsen, and then they will be admitted to hospital.”

And it worked. So why ban HCQ here? Is it because it works?