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Will Remdesivir deliver where Chloroquine did not? - Printable Version

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Will Remdesivir deliver where Chloroquine did not? - JustAnotherFan - 04-17-2020

Would love to hear people's thoughts on Remdesivir. Seems promising, no?

https://www.statnews.com/2020/04/16/early-peek-at-data-on-gilead-coronavirus-drug-suggests-patients-are-responding-to-treatment/

RE: Will Remdesivir deliver where Chloroquine did not? - JohnR34231 - 04-17-2020

(04-17-2020, 05:59 AM)JustAnotherFan Wrote:  Would love to hear people's thoughts on Remdesivir. Seems promising, no?

https://www.statnews.com/2020/04/16/early-peek-at-data-on-gilead-coronavirus-drug-suggests-patients-are-responding-to-treatment/

Preliminary data shows the drug could be very effective.
Until we get results of statistically sound tests with control groups and the like the jury is still out.
We should have the first of those in the next few weeks.

RE: Will Remdesivir deliver where Chloroquine did not? - JustAnotherFan - 04-17-2020

(04-17-2020, 06:06 AM)JohnR34231 Wrote:  
(04-17-2020, 05:59 AM)JustAnotherFan Wrote:  Would love to hear people's thoughts on Remdesivir. Seems promising, no?

https://www.statnews.com/2020/04/16/early-peek-at-data-on-gilead-coronavirus-drug-suggests-patients-are-responding-to-treatment/

Preliminary data shows the drug could be very effective.
Until we get results of statistically sound tests with control groups and the like the jury is still out.
We should have the first of those in the next few weeks.

If it is effective I am assuming that in addition to reducing the likelihood of a fatality for an individual, and given that it would shorten the duration that infected people needed to be hospitalized, that it would also substantially free up beds and ventilators (akin to increasing capacity), thereby reducing the fatality rate in heavy hit areas.

RE: Will Remdesivir deliver where Chloroquine did not? - dabigv13 - 04-17-2020

Remdesivir was always more promising because it has previously demonstrated in vitro effectiveness against SARS, and it makes sense based on its mechanism of action that it could help. 

I don't think it will be a miracle cure because I know docs who are using it and they aren't seeing miracle turnarounds on it or anything, but theres a chance it may help some folks, so getting controlled studies will be helpful.

RE: Will Remdesivir deliver where Chloroquine did not? - burger - 04-17-2020

Two large (200+ participants) studies in China were just cancelled because of inability to enroll enough people*.  These were supposed to be completed within a few weeks.  I'm assuming that high-quality studies from the US or Europe are still months out--all of the ongoing trials at the clinical trials database are still in the recruiting phase.

*I read somewhere that a big problem with Chinese studies was that nearly everyone takes traditional Chinese medicine when they get sick, and  Gilead insisted that the patients in the study not have taken any other drugs that could interfere with results.

RE: Will Remdesivir deliver where Chloroquine did not? - JustAnotherFan - 04-17-2020

(04-17-2020, 07:36 AM)burger Wrote:  Two large (200+ participants) studies in China were just cancelled because of inability to enroll enough people*.  These were supposed to be completed within a few weeks.  I'm assuming that high-quality studies from the US or Europe are still months out--all of the ongoing trials at the clinical trials database are still in the recruiting phase.

*I read somewhere that a big problem with Chinese studies was that nearly everyone takes traditional Chinese medicine when they get sick, and  Gilead insisted that the patients in the study not have taken any other drugs that could interfere with results.

I saw chatter that the Chinese may have ended the studies early because they were doing so well and they didn't want Gilead to corner the market. I have no idea whether I should give any weight to such a claim.

RE: Will Remdesivir deliver where Chloroquine did not? - akiddoc - 04-17-2020

A couple of ICU docs I know say if they were sick they would chose Remdesivir. I repeated that for myself over on CSR. It's the most logical choice at the moment if you are sick enough to be an inpatient. Subject to change, of course. This is all anecdotal at the moment.

RE: Will Remdesivir deliver where Chloroquine did not? - BostonCard - 04-17-2020

Something doesn't make sense about this article:

Quote:The University of Chicago Medicine recruited 125 people with Covid-19 into Gilead's two Phase 3 clinical trials. Of those people, 113 had severe disease. All the patients have been treated with daily infusions of remdesivir.

Pretty sure that a phase III trial would require a placebo arm.  If it is this study:
https://clinicaltrials.gov/ct2/show/NCT04292730?term=remdesivir&draw=2&rank=4

It was a controlled open-label study as best I can tell from the clinicaltrials.org page, so maybe they were just discussing the patients they knew who got remdisivir.

Bc

RE: Will Remdesivir deliver where Chloroquine did not? - fullmetal - 04-17-2020

I was hearing legitimate claims of remdesivir's effectiveness long before the (hydroxy)chloroquine hype train took off.  I remain puzzled as to why Trump never backed remdesivir in the first place.  Fingers crossed.

RE: Will Remdesivir deliver where Chloroquine did not? - BostonCard - 04-17-2020

One other point that I think echos akiddoc's, which is that there is a plausible biological mechanism for how remdesivir would work.  With chloroquine/hydroxychloroquine you have to make a bit of a hand-wavey argument of how it would help with COVID-19.  That doesn't mean it can't work; there are a lot of drugs out there that seem to work even though no one knows exactly how (including how hydroxychloroquine works in lupus).  But in terms of predicting success, I would think a drug with antiviral activity would be expected to work better than one without a clear mechanism of action.

BC

RE: Will Remdesivir deliver where Chloroquine did not? - BostonCard - 04-18-2020

https://www.fiercepharma.com/pharma/don-t-count-a-covid-19-vaccine-for-at-least-five-years-says-ai-based-forecast

Two interesting tidbits (and I don't claim to have any special insight into whether the company's AI based forcast are any better than a WAG, so your mileage may vary):

1) The PTS (probability of technical success) for Moderna's vaccine is low (5%) and its timeline is long 5.2 years.  I have a feeling that the AI is extrapolating out of sample in a way that is not relevant, and that in truth vaccine timelines will be much faster than one might predict based on historic data.

2) The PTS for remdisivir is 89%.  This strikes me as a bit optimistic for a drug that has not demonstrated efficacy in the disease under study yet.

BC

RE: Will Remdesivir deliver where Chloroquine did not? - BostonCard - 04-20-2020

The drug seems to work... in rhesus monkeys.

https://www.biorxiv.org/content/10.1101/2020.04.15.043166v1.full.pdf


Quote:Results: In contrast to vehicle-treated animals, animals treated with remdesivir did not show signs of respiratory disease and had reduced pulmonary infiltrates on radiographs. Virus titers in bronchoalveolar lavages were significantly reduced as early as 12hrs after the first treatment was administered. At necropsy on day 7 after inoculation, lung viral loads of remdesivir-treated animals were significantly lower and there was a clear reduction in damage to the lung tissue.

Conclusions: Therapeutic remdesivir treatment initiated early during infection has a clear clinical benefit in SARS-CoV-2-infected rhesus macaques. These data support early remdesivir treatment initiation in COVID-19 patients to prevent progression to severe pneumonia.


BC