22 February 2023

Remdesivir was the first approved drug against COVID-19 and is still in use today. However, several large-scale randomised trials showed different results. The first-authors Dr. Alain Amstutz and Dr. Benjamin Speich present now a paper in The Lancet Respiratory Medicine that analyses combined individual patient data from all randomized trials on this topic.


Since the outbreak of the COVID-19 pandemic, great efforts have been made to find effective treatments against the disease. Remdesivir has been studied as a promising drug in several randomised trials conducted internationally. However, the results of these large-scale trials have been controversial in terms of benefit for specific patient populations.


International collaboration and state-of-the-art data analysis methods

Under the lead of Prof.  Matthias Briel, head of the «CLEAR Methods Center», Clinical Epidemiology at DKF,  the study group established close contacts with international study teams and collected individual data from more than 10'000 patients from over 40 countries. Using the latest data analysis methods, the benefits, potential side effects, and subgroup effects were comprehensively investigated to determine which patient populations, if any, would benefit from remdesivir.


Benefit for patients without intensive ventilation support

The elaborate meta-analysis demonstrated that those patients hospitalised for COVID-19 who received no or only conventional oxygen support had a significant survival benefit from remdesivir. No clear benefit of remdesivir was demonstrated in those who received more intensive ventilatory support. Further subgroup analyses (e.g. by age or inflammatory markers) provided no evidence of differential benefit from remdesivir.

Furthermore, it became clear that remdesivir did not lead to more serious adverse events compared to usual care. The treatment effect of remdesivir in patients with acquired immune protection and the cost-effectiveness of remdesivir remain to be elucidated in further analyses.

The study was realised in close collaboration with the biostatistics team of the European Platform Study EU-SolidAct (https://eu-response.eu/eu-solidact/) and received financial support from the European Study Network EU-RESPONSE (https://eu-response.eu/).