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WHO warns against remdesivir for Covid-19 treatment


NEW DELHI: The World Health Organization (WHO) has now recommended against using the Ebola drug remdesivir in hospitalised Covid-19 patients. 

The recommendation comes over a month after its Solidarity Trial revealed that the antiviral, along with five other medicines tested, had no significant benefit for coronavirus patients.

The drug, which is manufactured by six Indian companies following their tie-ups with its proprietor US-based Gilead Sciences, had been granted emergency use authorisation in India for Covid-19 and is commonly used in moderate to severe patients.

An expert panel of the WHO, however, has now concluded that remdesivir, given intravenously, has no meaningful effect on mortality or on other important outcomes for patients, such as the need for mechanical ventilation or time to clinical improvement.

The report by the panel, published in the British Medical Journal on Thursday, did not rule out the use of the drug altogether as a Covid-19 treatment but said the evidence was lacking to recommend its use.

Since the beginning of the pandemic, the repurposed drug had generated much interest after it was shown to work against coronavirus in laboratory conditions.

The recovery trial, overseen by the US National Institutes of Health, had also suggested that the medicine helped Covid-19 patients recover and get out of the hospital faster than by about four days even though there was no impact on mortality.

The multi-country Solidarity Trial, for which several hospitals in India were also trial sites, however, said that remdesivir and other drugs studied “appeared to have little or no effect on hospitalized Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay.”

Some doctors, however, have been vouching for the medicine ever since it became available in India and say that the drug does work in many patients in their personal experience.

A research paper released on preprint server Medrxiv earlier this month by a group of doctors working with the Apollo Hospital in Bengaluru said that in 346 moderate to severe patients treated with the drug, initiation of remdesivir within nine days from symptom-onset was associated with a significant mortality benefit.

“These findings indicate a treatment window and reinforce the need for earlier remdesivir initiation in moderate-to-severe Covid-19 infection,” noted the researchers even though theirs was an observational and not a randomised control trial.

Many other medical practitioners, who support evidence-based medicine, however, have been criticising the continued use of the antiviral drug for the novel coronavirus, especially as it is expensive and still costs about Rs 20,000-24000 per course per patient. The use of the medicine for Covid-19 patients, they argue, helps the drugmakers rather than patients.