Dang! Here we go again.
Covid-19: Experts criticise claim that remdesivir cuts death rates
Published 14 July 2020 in the British Medical Journal
Experts have criticised pharmaceutical firm Gilead Sciences after it released data suggesting that its antiviral drug remdesivir can reduce death rates for patients with covid-19. They say the research is intrinsically flawed and that the claimed benefits are overhyped and inappropriately promoted in press releases.
The California based company said intravenous remdesivir reduced mortality by 62% compared with standard treatment in the SIMPLE trial of 1132 mainly US patients. Its data showed that 7.6% of covid-19 patients treated with the drug died compared with 12.5% of control patients.
Crucially, however, the study compared treatment and non-treatment groups in different cohorts treated in different conditions. The remdesivir patients were compared with a historical group of more than 800 patients on the “standard of care” of other drugs and oxygen.
Experts were quick to dismiss the significance of the results.
Martin Landray, professor of medicine and epidemiology at the University of Oxford and the lead research of the RECOVERY trial comparing treatments for covid-19, said, “What has been reported is an association—the results of comparing two rather different groups of patients. It’s impossible to draw any conclusions about the true effects of remdesivir on survival. For that we need robust evidence from large randomised controlled trials—and we simply don’t have that yet.”
Mainstream media were quick to report that the drug had been linked to a significant reduction in death rates. Within hours of the announcement on 10 July, Gilead’s share price rose 3%. The company has said that it will charge health systems in developed countries around £1900 (€2090; $2400) for a five day course of remdesivir.
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The decision to make it available to NHS patients was prompted by a report in the New England Journal of Medicine suggesting that remdesivir shortened the time to recovery by about four days.2 However, that data also proved controversial because the trial was stopped early and provided only preliminary results. In addition, it emerged that the primary clinical outcome had been changed after patients were randomised.
On the same day the NEJM study was published, the Lancet reported randomised, double blind, placebo controlled data from Chinese medics that suggested remdesivir showed no significant benefits in speeding recovery from covid-19 or reducing mortality.3
