In a new study, the antiviral drug remdesivir is not suggested for patients admitted to hospital with COVID-19, regardless of how severely ill they are, because there is currently no evidence that it improves survival or the need for ventilation.
The recommendation is part of a living guideline to provide trustworthy guidance on the management of COVID-19 and help doctors make better decisions with their patients.
The research was conducted by the WHO Guideline Development Group (GDG) panel of international experts.
Remdesivir has received worldwide attention as a potentially effective treatment for severe COVID-19 and is increasingly used to treat patients in hospitals.
But its role in clinical practice has remained uncertain.
The new recommendation is based on a new evidence review comparing the effects of several drug treatments for COVID-19. It includes data from four international studies involving over 7,000 patients hospitalized for COVID-19.
After thoroughly reviewing this evidence, the WHO GDG expert panel concluded that remdesivir has no meaningful effect on mortality or on other important outcomes for patients, such as the need for mechanical ventilation or time to clinical improvement.
The panel acknowledged that the certainty of the evidence is low and said the evidence did not prove that remdesivir has no benefit; rather, there is no evidence based on currently available data that it does improve important patient outcomes.
But given the remaining possibility of important harm, as well as the relatively high cost and resource implications associated with remdesivir (it must be given intravenously), they judged this to be an appropriate recommendation.
They also support continued enrollment into studies evaluating remdesivir, especially to provide higher certainty of the evidence for specific groups of patients.
The study is published in The BMJ.
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