4 ms·

From the methods summaries: "We conducted a double-blind, randomized, placebo-controlled trial of intravenous remdesivir in adults who were hospitalized with C

by rotexo 6y ago

From the methods summaries: "We conducted a double-blind, randomized, placebo-controlled trial of intravenous remdesivir in adults who were hospitalized with Covid-19 and had evidence of lower respiratory tract infection." [1] "In this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality." [2] These trials are explicitly about treating hospitalized patients, which is of course a group with a higher mortality than the general population. Nobody is saying otherwise. Remdesivir is administered intravenously, so it is unlikely you would try to deliver it to people with mild or asymptomatic infections. The comparison between the drugs in the general population would be very hard to do for that reason. Severe illness due to SARS-CoV-2 is such a huge problem that I'm not sure who would instead investigate a drug specifically for mild cases. [1] https://www.nejm.org/doi/full/10.1056/NEJMoa2007764?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMoa2007764?query=fe... [2] https://www.nejm.org/doi/full/10.1056/NEJMoa2022926?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMoa2022926?query=fe...

analyte123 6y ago
You investigate drugs for mild cases for the same reason you give Tamiflu within 48 hours of symptoms, that you excise malignant lesions before they metastasize, and that you put out a fire with an extinguisher instead of waiting it for it to burn down half the house so you can call the fire department.
- rotexo 6y ago
  Right, I didn't phrase that well. It would be nice to be able to treat covid early in the infection. However, research time and resources are limited. To work with your analogy, at the moment we are trying to put out the active fire of people at risk of death, rather than installing fire extinguishers and smoke alarms in an actively burning building.
- yokaze 6y ago
  Not if the drug costs US$2000-$3000 per treatment.
- DanBC 6y ago
  Do you know that tamiflu doesn't do much either? https://www.nhs.uk/news/medication/effectiveness-of-tamiflu-and-relenza-questioned/ https://www.nhs.uk/news/medication/effectiveness-of-tamiflu-... > It found that both drugs shorten the symptoms of influenza-like illness by about half a day in adults (but not in asthmatic children), compared to a placebo. There was no reliable evidence that either drug reduces the risk of people with flu being admitted to hospital or developing serious complications such as pneumonia, bronchitis, sinusitis or ear infection. Used as a preventative measure, Tamiflu and Relenza slightly reduced the risk of developing the symptoms of flu. The review also found no evidence that these drugs can stop people carrying the influenza virus and spreading it to others. > The study also found that Tamiflu slightly increases the risk of adverse effects such as nausea, vomiting, psychiatric and kidney problems in adults, and vomiting in children.

by rotexo 6y ago

analyte123 6y ago

You investigate drugs for mild cases for the same reason you give Tamiflu within 48 hours of symptoms, that you excise malignant lesions before they metastasize, and that you put out a fire with an extinguisher instead of waiting it for it to burn down half the house so you can call the fire department.

rotexo 6y ago
Right, I didn't phrase that well. It would be nice to be able to treat covid early in the infection. However, research time and resources are limited. To work with your analogy, at the moment we are trying to put out the active fire of people at risk of death, rather than installing fire extinguishers and smoke alarms in an actively burning building.
yokaze 6y ago
Not if the drug costs US$2000-$3000 per treatment.
DanBC 6y ago
Do you know that tamiflu doesn't do much either? https://www.nhs.uk/news/medication/effectiveness-of-tamiflu-and-relenza-questioned/ https://www.nhs.uk/news/medication/effectiveness-of-tamiflu-... > It found that both drugs shorten the symptoms of influenza-like illness by about half a day in adults (but not in asthmatic children), compared to a placebo. There was no reliable evidence that either drug reduces the risk of people with flu being admitted to hospital or developing serious complications such as pneumonia, bronchitis, sinusitis or ear infection. Used as a preventative measure, Tamiflu and Relenza slightly reduced the risk of developing the symptoms of flu. The review also found no evidence that these drugs can stop people carrying the influenza virus and spreading it to others. > The study also found that Tamiflu slightly increases the risk of adverse effects such as nausea, vomiting, psychiatric and kidney problems in adults, and vomiting in children.