Four repurposed drugs have little to no effect on Covid, says WHO

Coronavirus: Remdesivir has 'little effect' on death risks, says WHO

The study looked at how each of these treatments affected mortality, ventilator use, and length of hospital stay in patients that were hospitalized with COVID-19.

"We already knew that in sicker populations, it didn't really change outcomes", said Dr. Ken Lyn-Kew, a pulmonologist in the critical care section at National Jewish Health in Denver. "The drug is only part of it".

As scientific evidence emerged, the list was toned down to only Remdesivir and Interferon.

But health experts say the strength of the WHO trial lies in its size - 11,000 patients across 405 hospitals in 30 countries, with over 5,000 patients in the remdesivir arm - and its worldwide applicability. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, acknowledged at the time that remdesivir was not a "knockout" drug.

A final analysis, published in The New England Journal of Medicine on October 8, suggested "a trend toward reduced mortality" in certain patients receiving remdesivir, according to the drug's maker, Gilead.

The UN agency hired independent statistician and epidemiologist Richard Peto to evaluate its "Solidarity Therapeutics Trial" results after USA biopharmaceutical company Gilead criticized the WHO's methodology, saying the trial's findings appeared inconsistent with evidence from other studies.

Because of its design, there was "significant heterogeneity" in the way the trial was conducted. The results of the study are under review for publication.

Remdesivir had received regulatory approvals or temporary authorisations to treat COVID-19 in approximately 50 countries including India.

The drug costs $3,120 per treatment course for patients with private insurance in the United States.

The move was criticized by some experts, who said the FDA had made the shift without sufficient evidence.

"These Remdesivir, Hydroxychloroquine, Lopinavir and Interferon regimens appeared to have little or no effect on hospitalized COVID-19, as indicated by overall mortality, initiation of ventilation and duration of hospital stay", the researchers wrote in a preprint on the findings of the WHO's Solidarity trial that was released on medRxiv.

Of the more than 11,000 participants in the trial, 2,750 were given remdesivir; 954 HCQ; 1,411 only lopinavir-ritonavir; and 2,063 interferon. About 4,100 received no drug treatment.

In the end, no drug or combination reduced mortality, the chances that mechanical ventilation would be needed or time spent in the hospital, compared with the patients without drug treatment. The trial stopped using hydroxychloroquine and lopinavir in June. The trial found that there was little or no effect of these drugs on the outcome of COVID-19 over a 28-day period.

"The benefits of Veklury have been demonstrated in three randomized, controlled clinical trials, including a randomized, double-blind, placebo-controlled clinical trial - the gold standard for evaluating the efficacy and safety of investigational drugs". The WHO had announced the inefficacy of hydroxychloroquine and lopinavir/ritonavir against Covid-19 earlier this year. People infected with Covid-19 generally go through an initial phase of infectivity that could be impacted by an antiviral. Before that happens, an antiviral might tamp down the virus enough to protect a person from the immune system's friendly fire.



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