There have been high hopes that the antiviral drug remdesivir might be an answer to the pandemic of Covid-19. But a major, new study finds the drug on its own won't be enough to significantly curb cases and deaths.
The study, published May 22 in the New England Journal of Medicine, found that, "given high mortality [of patients] despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient."
The study of 1 063 Covid-19 patients was led by Dr John Beigel and Dr Clifford Lane at the National Institute of Allergy and Infectious Diseases (NIAID). The researchers found that remdesivir, delivered by infusion, did help ease the illness: Patients who got the antiviral recovered after an average of 11 days versus 15 days for those who hadn't received it.
Patients who were so sick they required supplemental oxygen, but did not need a ventilator to breathe, appeared to benefit most from remdesivir.
But the difference in the overall death rate - 7.1% of patients on the drug vs. 11.9% of those who didn't get it - did not reach statistical significance, the researchers said.
Combinations trialled
The study does suggest that early treatment works best. "Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation," the researchers said.
Early evidence had suggested that remdesivir might help fight coronavirus illness, so the US Food and Drug Administration gave it "emergency use authorisation."
The new trial is significant because it is the first double-blind, placebo-controlled trial to test the drug in patients. Double blind means that neither doctors nor patients knew whether remdesivir or a placebo was being used in a particular case.
Already, combinations of remdesivir and other drugs are being tried, to see if dual-drug treatments might boost outcomes even more.
For example, one federally funded clinical trial is combing remdesivir with a potent anti-inflammatory drug called baricitinib, while a trial from biotech firm CytoDyn is pairing it with an antiviral called leronlimab.
Vaccine efforts continue
Meanwhile, the search for an effective vaccine goes on. The US Department of Health and Human Services (HHS) said on Thursday it would provide up to $1.2bn to the drug company AstraZeneca to develop a potential coronavirus vaccine from Oxford University, in England.
The fourth, and largest, vaccine research agreement funds a clinical trial of the potential vaccine in the United States this summer with about 30 000 volunteers, The New York Times reported.
The goal? To make at least 300 million doses that could be available as early as October, the HHS said in a statement.
However, many experts have said that the earliest an effective, mass-produced vaccine would be available won't be until sometime next year, and billions of doses would be needed worldwide.
The United States has already agreed to provide up to $483m to the biotech company Moderna and $500m to Johnson & Johnson for their vaccine efforts. It is also providing $30m to a virus vaccine effort led by the French company Sanofi, the Times reported.
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