Dubious Results of Remdisivir Ultimately in Solidarity; Diversity of Severity of Illness is Doubtful

Hashemian, Seyed Mohammad Reza; Jamaati, Hamidreza; Norizadehtazehkand, Mostafa; Malkmohammad, Majid; Adimi, P; Amirsavadkouhi, Ali

doi:10.2174/0250688201999201120113151

Cited by 1 publication

(2 citation statements)

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“…The subgroup of patients not on mechanical ventilation showed a rate ratio for death of 0.86 (99% CI, 0.67-1.11), which was not significant but used an extremely conservative 99% CI. Commentators have suggested that Solidarity's failure to detect a benefit with remdesivir may be due to variations across trial sites in standards of care, timing of treatment initiation, intensive care unit standards, and disease burden [18,19].…”

Section: Discussionmentioning

confidence: 99%

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Remdesivir Versus Standard-of-Care for Severe Coronavirus Disease 2019 Infection: An Analysis of 28-Day Mortality

Olender

Walunas

Martínez

et al. 2021

Open Forum Infectious Diseases

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Background Remdesivir is FDA approved for the treatment of hospitalized patients with COVID-19 and has been shown to shorten time to recovery and improve clinical outcomes in randomized trials. Methods This was the final day 28 comparative analysis of data from a phase 3, randomized, open-label study comparing 2 remdesivir regimens (5 vs 10 days, combined for this analysis [remdesivir cohort]) and a real-world retrospective longitudinal cohort study of patients receiving standard-of-care treatment (non-remdesivir cohort). Eligible patients, aged ≥18 years, had confirmed SARSCoV-2, oxygen saturation ≤94% on room air or required supplemental oxygen, with pulmonary infiltrates. Propensity score matching (up to 1:10 ratio) was used to ensure comparable populations. We assessed day 14 clinical recovery (determined using a 7-point ordinal scale) and day 28 all-cause mortality (coprimary endpoints). Results Altogether, 368 (remdesivir) and 1399 (non-remdesivir) patients were included in the matched analysis. The day 14 clinical recovery rate was significantly higher among the remdesivir versus the non-remdesivir cohort (65.2% vs 57.1%; OR 1.49, 95% CI 1.16–1.90; P = .002). The day 28 mortality rate was significantly lower in the remdesivir cohort versus the non-remdesivir cohort (12.0% vs 16.2%; OR 0.67, 95% CI 0.47–0.95; P = .03). Conclusions Remdesivir was associated with significantly higher rates of day 14 clinical recovery, and lower day 28 mortality, compared with standard-of-care treatment in hospitalized patients with COVID-19. Collectively, these data support the use of remdesivir to improve clinical recovery and decrease mortality from SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 99%

“…a b [95% CI,[9][10][11] vs 15 [95% CI,[13][14][15][16][17][18] days; rate ratio for recovery, 1.29 [95% CI, 1.12-1.49]; P < .001)[11]. In addition, patients receiving remdesivir were more likely to have clinical improvement at day 15 than those receiving placebo (OR, 1.5, 95% CI, 1.2-1.9, after adjustment for disease severity).…”

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confidence: 99%