What is Remdesivir and why its’s effectiveness against Covid-19 is doubtful?

On May 1, 2020, US’s drug regulatory body Food and Drug Administration authorized the use of Remdesivir on an emergency basis for the treatment of severe Covid-19 patients.

A strong case for such a move was made by the director of the US National Institute of Allergies and Infectious Diseases, Dr Anthony Fauci who has been confident that the use of the drug has shown clear reduction in the recovery time of the patients during the trials.

Remdesivir durg for Covid-19
National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci answering questions on Covid-19
The new magic pill Remdesivir 

Remdesivir, an experimental anti-viral drug, has earlier been used for the treatment of Ebola in 2014, and even for MERS and SARS. But its success is still a matter of debate, which is why, it has not been sanctioned globally for any disease so far.

So, how does remdesivir work against Covid-19?

Well, it straight away attacks the enzyme RdRp which facilitates the replication of SARS-CoV2 inside the human cell and thus it shuts off virus’s replication process.Thus, the virus is not able to spread further in the bloodstream.

Are there any more clinical trials for remdesivir?

Currently, six major trials being done all over the world to test the effectiveness of remdesivir in Covid-19 patients-

    1. Solidarity trials under WHO
    2. SIMPLE study by Gilead Sciences
    3. National Institute of Allergies and Infectious Diseases trials in US
    4. DisCoVeRy study by the French institute Inserm
    5. Chinese Academy of Medical Sciences
    6. China-Japan Friendship Hospital in Wuhan, China

In the case of Covid-19, Gilead had started laboratory tests of remdesivir in January 2020, basing it on the fact that the drug has worked against SARS and MERS in animal models.

Is there a disagreement for the use of Remdesivir?

Yes some disagreement on the effectiveness of Remdesivir has come from very reputed sources.

Firstly, it is the WHO that released a small study in April 2020 in which very limited effect of Remdesivir was observed on corona patients in Wuhan.

Secondly, a reputed medical journal Lancet has contradicted the findings of Gilead on Remdesivir in its publication on 29th April, which quoted that “Remdesivir was not associated with statistically significant clinical benefits”.

Thirdly, in India, the chief operating officer of Lilavati Hospital in Mumbai, Dr. V. Ravishankar, is of the view that the use of Remdesivir in critical stage Covid-19 patients is too risky.

Despite all the disagreements, India might still see an active use of Remdesivir in future as Gilead is vigorously pursuing Medicines Patent Pool to get license for the use of Remdesivir in developing countries.

Health activists organizations, such as Third World Network and Cancer Patient Aid Association, are building pressure on the Indian government to revoke the patent of the drug. They are accusing patent offices of procedural lapse in granting the patent for Remdesivir.

WHO’s trial of Remdesivir and other drugs

While India has not been a part of Gilead’s Compassionate Use programme for research on Remdesivir, it has been active in its support to WHO’s Solidarity Group.

Solidarity Group trials is a multilateral effort with over 100 countries participating. It was launched on 18th March, 2020 and around 1650 patients from all over the world have been enrolled.

It involves randomized clinical trials with a reduced time frame of up to 80%. A single randomized trial will ensure a speedy comparison of unproven treatments around the world in times of a global emergency.

As long as these trials are inconclusive, it is difficult to pass a judgement on the usefulness of Remdesivir. Nonetheless, it is important to consider that US leadership had even earlier shown faith in the antimalarial drug hydroxychloroquine and was deeply disappointed.

Skepticism over the use of these drugs will continue to prevail until strong and universally applicable evidences are laid down. For that extensive testing is the only way.


Related

1.What is pooled testing and why has ICMR allowed it ?

2.How close are we to create a vaccine for Coronavirus

 

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