MONDAY, Nov. 23, 2020 — The use of remdesivir currently is not recommended for hospitalized COVID-19 patients because of the lack of evidence for improvement in mortality, need for mechanical ventilation, and other patient-important outcomes, according to a living guideline published online Nov. 20 in The BMJ.
Bram Rochwerg, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues examined the role of drug interventions in the treatment of COVID-19 in a living guideline, focusing on remdesivir, following the Oct. 15, 2020, preprint publication of results from the World Health Organization SOLIDARITY trial. To develop and disseminate living guidance for COVID-19 drug treatments, the WHO partnered with the Magic Evidence Ecosystem Foundation for methodologic support.
The new recommendation was weak or conditional against the use of remdesivir in hospitalized COVID-19 patients. The researchers emphasized that the evidence indicated no important effect on mortality, need for mechanical ventilation, time to clinical improvement, or other patient-important outcomes. Because the evidence was low or very low certainty for all outcomes, it was interpreted as not proving that remdesivir is ineffective; rather, no evidence is currently available that remdesivir does improve patient-important outcomes. Low value was placed on small and uncertain benefits in the presence of the possibility of important harms.
“This represents some of the strongest evidence yet that remdesivir is unlikely to be the lifesaving drug for the masses that many have hoped for,” U.S. journalist, Jeremy Hsu, writes in an accompanying feature article.
Living WHO Guideline
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