# Remdesivir?

**URL:** <https://boards.straightdope.com/t/remdesivir/852824>\
**Category:** The Quarantine Zone\
**Tags:** covid-quarantine\
**Created:** [April 29, 2020, 4:27pm UTC](https://boards.straightdope.com/t/remdesivir/852824 "2020-04-29T16:27:35Z")\
**Posts on this page:** 9\
**Page:** 1

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**Author:** ![Skypist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skypist/32/169_2.png) [@Skypist](https://boards.straightdope.com/u/Skypist)\
**Post date:** [April 29, 2020, 4:27pm UTC](https://boards.straightdope.com/t/remdesivir/852824/1 "2020-04-29T16:27:35Z")

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So today the stock market has gone up, supposedly because of the news that Gilead’s (what a name) early trials of remdesivir show promise as a treatment for COVID 19. However, from what I can tell it was a small group of patients with no control group. 8% of people in the 5-day treatment group and 11% in the 10-day treatment group died. Ten percent of the 10-day group had to DC treatment due to serious side effects. Receiving the drug earlier seemed to work better.

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**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\
**Post date:** [April 29, 2020, 5:41pm UTC](https://boards.straightdope.com/t/remdesivir/852824/2 "2020-04-29T17:41:51Z")

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> [@](#):
>
> Eight percent of the patients treated with five days of remdesivir died, compared to 11% of the patients treated for 10 days. Outside of Italy, where 77 patients were treated, the overall mortality rate across the entire study was 7%, Gilead said. Those mortality rates are lower than those seen in other studies, which have been in the teens and twenties.
> 
> Only 5% of patients in the five-day group and 10% in the 10-day group had side effects that led to a discontinuation. The most common bad effects — and it’s impossible to tell which were from the drug — were nausea and acute respiratory failure. High liver enzymes occurred in 7.3% of patients, with 3% of patients discontinuing the drug due to elevated liver tests.
> 
> A full evaluation of the results will have to wait until complete data are available.

> **[Critical study of Gilead's Covid-19 drug shows patients are responding to...](https://www.statnews.com/2020/04/29/gilead-says-critical-study-of-covid-19-drug-shows-patients-are-responding-to-treatment/)**
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> A government-run study of Gilead’s remdesivir, perhaps the most closely watched experimental drug to treat the novel coronavirus, showed that the medicine is effective against Covid-19, the disease caused by the virus.

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**Author:** ![Skypist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skypist/32/169_2.png) [@Skypist](https://boards.straightdope.com/u/Skypist)\
**Post date:** [April 29, 2020, 6:54pm UTC](https://boards.straightdope.com/t/remdesivir/852824/3 "2020-04-29T18:54:26Z")

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Fauci says he’s optimistic. Reduces recovery time from 15 days to 11. WHO says it’s too early to comment.

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**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\
**Post date:** [April 29, 2020, 7:21pm UTC](https://boards.straightdope.com/t/remdesivir/852824/4 "2020-04-29T19:21:52Z")

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Last I saw, data were very limited and inconclusive and even contradictory, and that meaningfully large clinical trials were either still in the planning or recruitment stages.

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**Author:** ![Skypist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skypist/32/169_2.png) [@Skypist](https://boards.straightdope.com/u/Skypist)\
**Post date:** [April 29, 2020, 7:33pm UTC](https://boards.straightdope.com/t/remdesivir/852824/5 "2020-04-29T19:33:24Z")

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Yeah, I guess I’m just trying to figure out how “excited” to get over this but it may be too soon to tell. I’m just a bit surprised Fauci is saying he’s optimistic because I could see that as causing public over-confidence. It sounds like this drug could possibly be given emergency permission to be used. Not sure how long that would take if it happens.

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**Author:** ![Corry\_El](https://avatars.discourse-cdn.com/v4/letter/c/ecae2f/32.png) [@Corry\_El](https://boards.straightdope.com/u/Corry_El)\
**Post date:** [April 29, 2020, 8:20pm UTC](https://boards.straightdope.com/t/remdesivir/852824/6 "2020-04-29T20:20:31Z")

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> [@Skypist](#):
>
> I’m just a bit surprised Fauci is saying he’s optimistic because I could see that as causing public over-confidence.

I think there’s already probably too much shading of information based on second guessing ‘how the public might misinterpret it’. I would hope Fauci and people in similar positions would say exactly what they think about all aspects of the COVID problem\*, and not filter it by trying to guess what honest statement would ‘cause public over confidence’. Especially now that a high % of people (not everyone) realizes COVID is a serious problem, and only a small % are any longer on the verge of panic, it being pretty clear it’s a serious problem that’s not the end of the world.

\*I supposed a natural retort might be to insinuate that even non-political appointee federal medical bureaucrats like Fauci are shading the information to make Trump look good, or less bad. I don’t know, but would hope they refrain from that also.

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**Author:** ![Skypist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skypist/32/169_2.png) [@Skypist](https://boards.straightdope.com/u/Skypist)\
**Post date:** [April 29, 2020, 9:50pm UTC](https://boards.straightdope.com/t/remdesivir/852824/7 "2020-04-29T21:50:16Z")

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I see what you’re saying. The public needs to be told what’s going on. I guess I just personally suspect Fauci might be a little too enthusiastic about it. I’m on my phone so it’s difficult to link right now, but what I have seen today says that remdesivir is currently not approved for any condition and any reduction in death rate is not statistically significant.

That actually wouldn’t be too far off from medications like Tamiflu that I believe are in the same antiviral medication category. Tamiflu may shorten the length of time a person suffers flu symptoms but hasn’t been shown to actually reduce the incidence of hospitalizations or deaths from the flu, if I recall correctly. Please correct me if I’m wrong. It sounds to me, though it’s early on, that remdesivir may give similar results for COVID 19. IOW it’s not guaranteed to save you if you catch it.

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**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\
**Post date:** [April 30, 2020, 12:34am UTC](https://boards.straightdope.com/t/remdesivir/852824/8 "2020-04-30T00:34:08Z")

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What I heard him saying was the the good news is a drug can have an effect. Which means that there is reason to believe a variation on that drug might have a better effect.

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**Author:** ![echoreply](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/echoreply/32/3641_2.png) [@echoreply](https://boards.straightdope.com/u/echoreply)\
**Post date:** [May 24, 2020, 5:25am UTC](https://boards.straightdope.com/t/remdesivir/852824/9 "2020-05-24T05:25:16Z")

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[A double blind study on Remdesivir shows promising results](https://www.nejm.org/doi/full/10.1056/NEJMoa2007764?query=featured_home&mod=article_inline). The bottom line is that those in the treatment group had a median recovery of 11 days compared to 15 in the placebo group. This is a significant difference with p \<0.001. The treatment group had lower percentage of deaths, too, but it was not a statistically significant difference. Both groups also had many patients with adverse events, but the adverse events were not significantly higher in the treatment group than the placebo group.

So based on this study, we can say with some confidence that Remdesivir has positive effects, and even if it does have side effects they do not appear to be worse than what happens to people with a bad enough case of Covid-19 to require hospitalization. It is not a cure, and could not be shown to prevent deaths.

Having read through it I’m left with a few different questions. The study was conducted at several sites in North America, Europe, and Asia, but I did not see any analyses of differences in outcome by study location. Maybe I just missed it, because it is a very obvious thing to look at.

The patients were stratified into several severity classes.

4: hospitalization, but no supplemental oxygen  
5: supplemental oxygen required  
6: high flow oxygen  
7: ventilator

Patients in group 5 showed the biggest difference between the treatment and placebo groups. Overall the treatment had a significant effect, but only group showed a significant effect within the group. That is almost certainly because that is the largest group by a big margin (about 400 in group 5, compared to 100-300 in the other 3 groups).

The study has about 500 subjects in the treatment group and 500 in the placebo group, and claims to have 85% power to detect a recovery rate ratio of 1.35, and that seems to be about what they found. It does seem underpowered to answer questions of mortality, and to answer questions about sub-groups.