Carpen says no plans yet to discontinue use of remdesivir in COVID-19 treatment

-after WHO trial casts doubt on effectiveness

October 18 ,2020

Source

Following the World Health Organization (WHO) publication of research from a clinical trial showing that remdesivir barely reduces the mortality rate of COVID-19 patients, member of the Georgetown Public Hospital’s Task Force for COVID-19 Dr Mahendra Carpen has said that there are no immediately plans to discontinue using it to treat patients here as it seems to be reducing the amount of time those with symptoms remain hospitalised.

The non-peer-reviewed preprint WHO study found that interim results from the Solidarity Therapeutics Trial indicates that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.

The study looked at the effects of those treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalised patients. The study lasted for a period of six months.

During an interview yesterday, Carpen told Sunday Stabroek that despite the disappointing WHO data, local authorities will continue to use remdesivir to treat patients with mild symptoms of COVID-19 at least until more definitive results are released.  He stated that at this point, it is important to note that the trial has not yet been subjected to independent review or analysis, which is normally required before a study is accepted as a game-changing standard of care.

In addition, he said, since they began using the drug to treat COVID-19 patients, there is no evidence of it causing harm to patients.

“We will await some of the more definitive evidence but what is encouraging is that it did not show that it causes harm to patients. I believe that the majority persons around the world will continue to use remdesivir until we have more evidence and I believe it’s a reasonable approach and it’s difficult to change what has become standard of care,” he said before adding that the trials ended prematurely.

He further noted that no one claimed that remdesivir is a life-saving treatment and that that was never a question. “So we will not make changes to what we have been doing across the world. It’s not just Guyana but there are countries across the globe that will continue to use it,” he said.

Carpen noted, however, that in Guyana, they observed that it has reduced the time that a persons with symptoms spends in the hospital or in the Intensive Care Unit (ICU). He revealed that they were able to transfer several patients from the ICU to isolation settings in a faster period than before.

When asked how many days a person with COVID-19 symptoms stays in the hospital, Carpen stated that some may spend a day or at least two weeks.

Previously, Carpen had said use of antiviral medication remdesivir to treat on COVID-19 patients in Guyana has been promising. The drug, which has been around for quite some time, was first touted as a potential treatment for the Ebola disease but did not show much promise. “But now with the COVID-19 pandemic they decided to give it a try and early indicators were encouraging for the patients who were given this drug,” Carpen had explained.

Meanwhile, WHO also said newer antiviral drugs immunomodulators and anti-SARS COV-2 monoclonal antibodies are now being considered for evaluation.