- A small evidence base suggests benefits for remdesivir in the treatment of COVID-19.
Why this matters
- Remdesivir remains investigational, with limited-use authorizations hurried through in spring.
- Trial enrollment continues.
- Remdesivir vs placebo (2 studies):
- Mortality: absolute risk difference (ARD), −4% to 1% (low certainty).
- Recovery: ARD, 7%-10% (moderate certainty).
- Serious adverse events (SAEs): ARD, −8% to −6% (moderate certainty).
- Remdesivir, 5 vs 10 days (2 studies):
- Mortality: reduced (low certainty), except among patients requiring invasive ventilation or extracorporeal membrane oxygenation who may do better with a 10-day course.
- Recovery or clinical improvement: improved (low certainty).
- Time to recovery: reduced.
- SAEs: reduced.
- Length of stay (LOS): no effect.
- A systematic review of 4 randomized trials, January-August 2020, assessing remdesivir treatment in adult patients with COVID-19.
- Outcomes: death, recovery, hospital LOS, SAE.
- Funding: US Department of Veterans Affairs.
- 2 trials were open label, 1 was a preliminary report.
- Most patients were white men around age 60 years.
- Adults with pregnancy or with severe kidney or liver disease were excluded.
- Insufficient data for meta-analysis.