Remdesivir DBRPCT....

1,874 Views | 12 Replies | Last: 3 yr ago by Fitch
Marcus Aurelius
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AG
https://www.nejm.org/doi/full/10.1056/NEJMoa2007764?query=featured_home

Sorry about the triple post

DBRPCT trial of remdesivir vs placebo in COVID-19. 1063 pts.

"Remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with Covid-19 and evidence of lower respiratory tract infection."
OldArmy71
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It's 1063 patients.

Is this the study we heard about that was stopped because remdesivir was so much better?
Marcus Aurelius
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Not sure. But finally a well done study. Looks like remdesivir if effective given at admission.
Not a Bot
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Love the breakdown by oxygenation need. Very well put together study.

Looks like the people who benefit the absolute most are the people requiring supplementary oxygen but who are not ventilated. It looks like ventilator patients actually do slightly worse than the placebo. People need to be on this early and there should NOT be an ICU status requirement to receive it. Absolutely looks like the earlier it is given, the better.

The problem of course is that because the drug is still not completely available everywhere a lot of doctors and hospitals are going to hold this for the most severe cases, which this data suggests is the absolute worst thing to do.
Infection_Ag11
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The breakdown by oxygen requirements is awesome
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Fitch
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If I remember correctly this was mentioned in an Oval Office "couch conference" as exhibiting positive data pointing towards shortened morbidity.
amercer
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I believe this is the study that the NIH had a press conference about last week. Not a miracle cure, but effective and probably more so in early stages. If you are having a cytokine storm, stopping viral replication doesn't do you much good.

The problem now is there isn't nearly enough to treat severe cases, much less mild ones.
Marcus Aurelius
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Tocilizumab is effective for storm. Numerous anecdotal success with it. And several studies showing its success. Our pharmacy now has remdisivir and tocilizumab in stock.
KlinkerAg11
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How are you holding up hospital capacity wise?
Marcus Aurelius
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COVID19 unit full. Been constant.
KlinkerAg11
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Is it still nursing home outbreaks?
amercer
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Marcus Aurelius said:

Tocilizumab is effective for storm. Numerous anecdotal success with it. And several studies showing its success. Our pharmacy now has remdisivir and tocilizumab in stock.


Right. My point was that pretty much all antivirals are most effective early.

I'm actually pretty hopeful that immunomodulation is going to save a lot of lives. We know a bunch about how to tweak the system now. There was an interesting report today about using IL7 to boost the T cell response.
Marcus Aurelius
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We are holding steady. Same volume. Vast majority SNF pts.
Fitch
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You've been posting here the whole duration of this. #1 thank you. #2 hope you're taking care of yourself. I can't imagine the marathon has been easy.
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