5 ms·

Derek Lowe recently discussed results from a different trial that were more positive. https://blogs.sciencemag.org/pipeline/archives/2020/10/09/hard-data https

Derek Lowe recently discussed results from a different trial that were more positive. https://blogs.sciencemag.org/pipeline/archives/2020/10/09/hard-data https://blogs.sciencemag.org/pipeline/archives/2020/10/09/ha... > The good news is that the patients receiving the drug had a shorter time to recovery (9 to 11 days, in the 95% confidence interval, versus 13 to 18 days with non-remdesivir standard of care. That’s real, but it’s not real dramatic, either, which is what you would realistically expect from a single broad-spectrum antiviral drug. This ain’t sofosbuvir clearing out hepatitis C, and even that one doesn’t do the job by itself. As for the hardest endpoint of all, mortality by Day 29 for these patients was 11.4% with remdesivir therapy as compared to 15.2% with the controls. So again, that’s a real improvement and very much worth having, but it’s not a Miracle Drug, either. Adverse events were actually lower in the treatment group, which is of course good news.

boomboomsubban 6y ago
The BBC article mentions that study and says it was conducted by Gilead. The study itself says that Gilead employees took part, but I am unable to figure out what role they actuality played.
hhs 6y ago
If interested, he posted an updated comment that takes into account today’s news of the Solidarity trial: https://blogs.sciencemag.org/pipeline/archives/2020/10/16/the-solidarity-data https://blogs.sciencemag.org/pipeline/archives/2020/10/16/th...
- Balgair 6y ago
  "It looks like there is no case at all to be made for some of these therapies, and for remdesivir, it looks like the argument now is “Does it help a bit or just not at all?” The only thing that I’ve seen that really seems to be making a big difference now is dexamethasone, and we may soon (I hope) be adding the monoclonal antibodies to that list. The SOLIDARITY enrollment is still moving along at 2000 patients/month, and will be looking at these and other newer ideas as it continues. And that means abandoning the older ideas, because – as we’re finding out – they’re not much help. It’s time to move on." Just so everyone knows, this is the same guy that writes the 'Things I Won't Work With" blog. It's all about insane chemical compounds and is very much one of the best blogs ever written. https://blogs.sciencemag.org/pipeline/?s=things+I+won%27t+work+with https://blogs.sciencemag.org/pipeline/?s=things+I+won%27t+wo...
  - jessaustin 6y ago
    Dexamethasone is a bit of a wonder drug. It might not save your life, but you'll certainly feel better for a couple of days. Earlier this week I gave some to a calf that hadn't had the strength to walk out of the corral for days. The next morning I found it running around.
    - Balgair 6y ago
      Prednisone as well. Donny was right about them, they really do make you feel 20 years younger. Shame about the liver and kidneys though.
tlburke 6y ago
Well Remdesivir was originally developed as a treatment for Ebola before the current pandemic, so it isn't a specialized treatment for COVID-19. The fact that it has small and diffuse effects was totally predictable.
fennecfoxen 6y ago
I am posting to point out that one of the reasons it’s very much worth having is the “real, but not dramatic” improvement in recovery times you note. There are substantial expenses on hospital stays — one reason why they set the price where it is, it pays for itself easily — and it flattens the tip of the “hospitalized patients” curve, leaving more room in case more are ill.
- epmaybe 6y ago
  As someone who sees covid patients regularly, my anecdata seems to suggest that the remdesivir 5day/dexamethasone 10day combo really does help get these patients out of the hospital. There's just so many things that can go wrong while you're in the hospital, if there's a safe way to get you out earlier, we'll take it.
  - beagle3 6y ago
    Do you have any anecdata about dex wihout remdesivir? (Not trying to be a jerk, but based on your anecdata, it's equally likely that remdesevir/dex/twinkie would really help as well; We know dex makes a huge difference from several well done tests. The question is whether remdesivier and twinkie have any effect, indepedently or in combination)
    - epmaybe 6y ago
      Yea, I didn't try to say anything about the efficacy of remdesivir vs dexamethasone because our hospital rarely does dexamethasone without remdesivir (though that may change soon based on the solidarity results). I've seen it a few times (if the patient has underlying liver disease, for example), and they have generally done fine. That being said...most patients do just fine, so it's hard to draw many conclusions.

boomboomsubban 6y ago

The BBC article mentions that study and says it was conducted by Gilead. The study itself says that Gilead employees took part, but I am unable to figure out what role they actuality played.

hhs 6y ago

If interested, he posted an updated comment that takes into account today’s news of the Solidarity trial: https://blogs.sciencemag.org/pipeline/archives/2020/10/16/the-solidarity-data https://blogs.sciencemag.org/pipeline/archives/2020/10/16/th...

Balgair 6y ago
"It looks like there is no case at all to be made for some of these therapies, and for remdesivir, it looks like the argument now is “Does it help a bit or just not at all?” The only thing that I’ve seen that really seems to be making a big difference now is dexamethasone, and we may soon (I hope) be adding the monoclonal antibodies to that list. The SOLIDARITY enrollment is still moving along at 2000 patients/month, and will be looking at these and other newer ideas as it continues. And that means abandoning the older ideas, because – as we’re finding out – they’re not much help. It’s time to move on." Just so everyone knows, this is the same guy that writes the 'Things I Won't Work With" blog. It's all about insane chemical compounds and is very much one of the best blogs ever written. https://blogs.sciencemag.org/pipeline/?s=things+I+won%27t+work+with https://blogs.sciencemag.org/pipeline/?s=things+I+won%27t+wo...
- jessaustin 6y ago
  Dexamethasone is a bit of a wonder drug. It might not save your life, but you'll certainly feel better for a couple of days. Earlier this week I gave some to a calf that hadn't had the strength to walk out of the corral for days. The next morning I found it running around.
  - Balgair 6y ago
    Prednisone as well. Donny was right about them, they really do make you feel 20 years younger. Shame about the liver and kidneys though.

tlburke 6y ago

Well Remdesivir was originally developed as a treatment for Ebola before the current pandemic, so it isn't a specialized treatment for COVID-19. The fact that it has small and diffuse effects was totally predictable.

fennecfoxen 6y ago

I am posting to point out that one of the reasons it’s very much worth having is the “real, but not dramatic” improvement in recovery times you note. There are substantial expenses on hospital stays — one reason why they set the price where it is, it pays for itself easily — and it flattens the tip of the “hospitalized patients” curve, leaving more room in case more are ill.

epmaybe 6y ago
As someone who sees covid patients regularly, my anecdata seems to suggest that the remdesivir 5day/dexamethasone 10day combo really does help get these patients out of the hospital. There's just so many things that can go wrong while you're in the hospital, if there's a safe way to get you out earlier, we'll take it.
- beagle3 6y ago
  Do you have any anecdata about dex wihout remdesivir? (Not trying to be a jerk, but based on your anecdata, it's equally likely that remdesevir/dex/twinkie would really help as well; We know dex makes a huge difference from several well done tests. The question is whether remdesivier and twinkie have any effect, indepedently or in combination)
  - epmaybe 6y ago
    Yea, I didn't try to say anything about the efficacy of remdesivir vs dexamethasone because our hospital rarely does dexamethasone without remdesivir (though that may change soon based on the solidarity results). I've seen it a few times (if the patient has underlying liver disease, for example), and they have generally done fine. That being said...most patients do just fine, so it's hard to draw many conclusions.