During the pandemic several therapeutic agents were evaluated for treatment of covid-19, one of the well known ones was Remdesivir. Remdesivir also known by its brand name Veklury, is normally used in adults and children above the age of 12, who were diagnosed with Covid-19 and lower respiratory tract illness, through intravenous (IV) infusion. The period of it's administration was 10 days.

Remdesivir, is a nucleotide-analog prodrug that inhibits the viral RNA-dependent RNA polymerase, it was approved by Food and Drug Administration (FDA) in October 2020. It was originally developed for treatment of hepatitis C and was studied for ebola virus and marburg virus infections before being studied for post-infectious treatment of covid-19.

In May 2020, the first report of an effective treatment for covid-19 was provided in a journal, resulting from rigorously designed and conducted clinical trials. A randomized, placebo-controlled trial of potential antiviral treatment for a disease whose pathogenesis is unclear was carried out internationally during the pandemic.

The primary outcome of this trial was- time of recovery. Results of the final report showed that the time of recovery was significantly less amongst patients who received remdesivir than among those who received placebo. A trend towards lower mortality was observed among patients who received remdesivir than among those who received placebo, but the differences did not reach statistical significance.

The FDA issued an emergency use authorization for remdesivir to treat adults and children hospitalized for covid-19. Remdesivir must be administered intravenously, which represents a limitation on its use. Use of Remdesivir was associated with lower need for more intensive respiratory support, but it did not improve outcomes of patients who were on mechanical ventilation. The findings in the trial suggest that the timing of initiation of treatment with an antiviral such as remdesivir, as well as the underlying clinical status of the patient, may have important effects on the outcomes. The trial was also conducted under an adaptive design platform that allowed participants to receive other therapies for covid-19 that were permitted by officials. Sensitivity analysis did not show an effect of concomitant glucocorticoids on results, but it will be important to identify effects that other co-therapies might have that are approved by medical professionals.

Remdesivir can cause various side effects that may include low/ high blood pressures, dizziness, nausea, vomiting, some allergic reactions like itching/ swelling, rash, severe dizziness, troubled breathing. Some medical conditions taken into consideration before remdesivir treatment include kidney disease, liver disease.

Remdesivir primarily arrests replication of viruses and prevents the progression of the disease. However, given the high mortality rate despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient for all patients. Current strategies are evaluating remdesivir in combination with immune response modifiers. Remdesivir provides moderate clinical benefit in the treatment of patients with Covid-19. These findings are a step forward on the road to developing effective therapy for SARS-CoV-2 infections and, as such, is one of the important advances in medical sciences.

Kasturi Kadam

S. Y. B. Pharm.

Tags: MET Institute of Pharmacy