- Preliminary findings from the first placebo-controlled trial of remdesivir for COVID-19 show shortened recovery time in hospitalized adults.
- Mortality was numerically lower with remdesivir but did not reach significance.
Why this matters
- Remdesivir may offer benefit in terms of shortened recovery time.
- Mortality benefit, if any, is unclear.
- Double-blind, randomized, placebo-controlled analysis of intravenous remdesivir (200-mg loading dose+100 mg/day up to 9 days) in 1059 patients (538 remdesivir, 521 placebo) with laboratory-confirmed COVID-19.
- Researchers used an 8-category ordinal scale to track recovery from baseline; a low score indicates better status.
- Funding: NIH.
- Mean age, 58.9 years; 64.3% male.
- 27.0% had 1 comorbidity; 52.1% had ≥2 comorbidities.
- Time to recovery: 11 days with remdesivir vs 15 days with placebo (P<.001>
- Rate ratios for recovery (95% CIs) were better with lower baseline ordinal scale scores:
- Baseline, 4 (n=127): 1.38 (0.94-2.03).
- Baseline, 5 (n=421): 1.47 (1.17-1.84).
- Baseline, 6 (n=197): 1.20 (0.79-1.81).
- Baseline, 7 (receiving mechanical ventilation or extracorporeal membrane oxygenation, n=272): 0.95 (0.64-1.42).
- Rate ratio for recovery for adjusted treatment effect (n=1017): 1.31 (1.12-1.54).
- Mortality (HRs; 95% CIs) at day 14:
- Overall: 0.70 (0.47-1.04).
- Adjusted, remdesivir: 7.1% (5.0%-9.9%).
- Adjusted, placebo: 11.9% (9.2%-15.4%).
- Protocol changes.
- Remote follow-up.