Remdesivir is an antiviral drug developed and produced using ethical means. However, results have been weak in preventing both hospitalizations and death. Additionally, itʼs cost is exorbitant at $1,000 per treatment.
What about the highly anticipated therapy known as Remdesivir? Is it an ethical and effective option in beating COVID-19? An excerpt from a recently published article follows.
By Jon Cohen
. . . What’s the evidence for using remdesivir in COVID-19 patients?
Remdesivir is an antiviral drug developed by Gilead Sciences, originally to treat the hepatitis C virus. It did not perform well against that pathogen but has been tried against Ebola and other viruses, after showing some activity in cells and animal models. The drug inhibits a viral enzyme used for replication of the pathogen. Earlier this year, it demonstrated a modest clinical benefit in a trial with hospitalized COVID-19 patients, leading FDA to grant Gilead an EUA for the drug. That EUA has since been expanded for use in patients with mild disease although its benefit in them is not clear. The drug has become widely used for COVID-19 patients despite continuing skepticism that it has a major clinical benefit. Because it and the monoclonal antibodies target different parts of the virus, administering them together may have a synergistic effect. One COVID-19 clinical trial is testing remdesivir and Lilly’s antibody, for example.
Why was a steroid added to his treatment?
On 4 October, Sean Conley, the White House physician, said in a press conference that Trump had also been started on the steroid dexamethasone. The drug dampens the body’s immune response and can keep it from wreaking havoc in the late stages of COVID-19. It is the only treatment so far that has been shown to reduce the mortality in patients with severe COVID-19, but there are some indications that it may actually be harmful if given too early in the disease course. In the United Kingdom’s Recovery trial there was a clear benefit for patients requiring oxygen or ventilation but not for other patients. Conley said Trump had experienced “two episodes of transient drops in his oxygen saturation.” Independent doctors were quick to point out that dexamethasone can have serious side effects including agitation, paranoia, and even psychosis.
Is the president receiving any other COVID-19 treatments?
The statement released on 2 October by the president’s physician said that in addition to the antibodies, Trump “has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin.” That wording leaves unclear whether he was taking those substances before his diagnosed infection. Notably, the statement does not indicate whether Trump was or is taking hydroxychloroquine, the antimalarial he controversially pushed as a COVID-19 treatment.
Famotidine has been suggested to be a treatment for COVID-19, but it’s also a popular heartburn remedy, sold widely under the name Pepcid. A clinical trial testing it in hospitalized COVID-19 patients in New York was not able to recruit enough patients to properly evaluate its impact. The Feinstein Institutes for Medical Research, which initiated that trial, released a statement on 2 October citing evidence it was helpful for COVID-19 but also saying, “We have yet to prove [famotidine’s] efficacy.” The institute says it’s “eagerly awaiting” FDA approval of a trial that will evaluate whether famotidine can help people who are not hospitalized.
This story was originally published on 2 October at 9:25 p.m.
*Update, 3 October, 1:20 p.m.: Information about Trump’s use of remdesivir was added to the story.
*Update, 5 October, 9:15 a.m.: Information about Trump’s use of dexamethasone was added to the story.
*Update, 7 October, 3:55 p.m.: Information about the Regeneron treatment was added to this story.
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