The news has been conflicting about the use of Remdesivir against COVID-19 infection. One day, the news reports that the treatment with Remdesivir shows some promise, and the next day, we are told that there is no real promise. So which is it?
In this article, we will go over everything you need to know about Remdesivir so far, including what it is used for, how much it costs, how it’s administered, how it is thought to work against the novel coronavirus (SARS-CoV-2) which causes COVID-19, the FDA’s Emergency Use Authorization (EUA), and more.
What is Remdesivir?
Remdesivir, sold under the name Veklury, is an investigational antiviral medication which has been used for the treatment of COVID-19. It is used in both adults and children with COVID-19-related pneumonia requiring supplemental oxygen. Though initially discovered by Gilead Sciences to treat Ebola, Remdesivir failed to show sufficient efficacy against Ebola in 2018.
How does Remdesivir work?
Remdesivir is an adenosine analogue (like a doppelgänger of adenine) which blocks viral replication by competitively binding to RdRp (RNA-dependent RNA polymerase) — a binding site typically occupied by adenine.
RdRp is a protein which is important in copying the viral RNA (the genetic material) of the SARS-CoV-2 virus. When Remdesivir binds to RdRp, it prevents the virus from multiplying inside our cells. This preventative measure that Remdesivir offers is necessary to halt the COVID-19 infection mechanism.
How much does Remdesivir cost?
According to NPR, Remdesivir in the United States costs $520 per vial for patients with private insurance, although some government programs may offer the drug at a lower price. For developed countries outside of the US, Remdesivir costs $390 per vial or $2,340 for the five-day course. According to the Times, a five-day regimen of Remdesivir costs approximately £1,900 in the UK.
How is Remdesivir administered?
Remdesivir commonly comes as a liquid solution that is infused into the vein over 30 to 120 minutes. It is administered by IV infusion. It is usually given once a day for a total of 5 to 10 days depending on how well your body responds to medication.
What side effects can Remdesivir cause?
The most common side effect in healthy volunteers receiving Remdesivir has been the increase of liver enzymes in the blood. In patients with COVID-19, the most reported side effect has been nausea. However, since Remdesivir has only recently been studied for use against the novel coronavirus (SARS-CoV-2), a number of side effects to the drug are unknown. Adverse effects associated with the drug will become more apparent with widespread use of Remdesivir.
If you experience a serious side effect while receiving Remdesivir treatment in the United States, you or your doctor may send a report to the Food and Drug Administration’s MedWarch Adverse Event Reporting program online here or by phone (1-800-332-1088). Similar reporting stations are available worldwide, and we encourage that you ask your doctor where you can report your symptoms.
What do clinical trials have to say about the use of Remdesivir against COVID-19 infection?
A trial spearheaded by the National Institutes of Health trialled Remdesivir in 1,063 patients hospitalised with COVID-19. The results of this study suggested that Remdesivir shortened the recovery rate of patients by up to 31%, although no significant change to mortality was observed. This study prompted the FDA to authorise the use of Remdesivir for COVID-19 infection.
What’s happening with the FDA’s Emergency Use Authorization for Remdesivir against COVID-19?
The United States Food and Drug Administration has authorised the emergency use of Veklury (Remdesivir) for COVID-19 patients on May 01, 2020. Currently, the EUA covers the use of Veklury to children with suspected or laboratory confirmed COVID-19 aged less than 12 years and weighing 3.5kg-40kg. Clinical trials assessing the safety and efficacy of Veklury in pediatric patient populations are currently ongoing.
Has Remdesivir been approved for COVID-19 treatment?
On 22 October, 2020, The FDA approved the first treatment for COVID-19 — Remdesivir (or Veklury). The drug has been approved for use in adults and children (aged 12 years and older) for the treatment of COVID-19 that requires hospitalisation.
Please keep in mind that this approval does not include the entire population like the EUA did originally. As it stands, the drug has been approved for use in adults and children over the age of 12, but not in children under 12. Children under 12 weighing 3.5kgs-40kgs are currently covered under the EUA.
What did the World Health Organisation’s Solidarity have to say about Remdesivir?
On October 15, 2020, the solidarity trials launched by the World Health Organisation concluded that Remdesivir had little or no effect on overall mortality, initiation of ventilation and duration of hospital stay in hospitalised patients.
Can Remdesivir be used for the prevention of COVID-19?
A number of people have asked about the use of Remdesivir for COVID-19 prevention. The drug has received EUA for use in patients that are COVID-19 positive. Taking the drug as a preventative is not suggested – in fact, Remdesivir is not available over the counter and can only be administered in the presence of a medical professional.
Didn’t President Donald Trump receive Remdesivir treatment?
Yes. President Trump received Remdesivir treatment alongside polyclonal antibodies developed by Regeneron Pharmaceuticals.
Keep an eye out for our post on Regeneron’s magic drug which will be published later this week. In the mean time, check out our COVID-19 resource page for similar posts on the top COVID-19 vaccines in Phase 3 clinical trials.
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