WHO advises against use of remdesivir for COVID-19

The antiviral drug remdesivir is not suggested for patients admitted to hospital with the novel coronavirus (COVID-19) regardless of how severely ill they are, because there is currently no evidence that it improves survival or the need for ventilation, according to a new World Health Organization (WHO) Guideline Development Group (GDG) recommendation published in The BMJ.

The recommendation is based on a new evidence review comparing the effects of several drug treatments for COVID-19. It includes data from four international randomized trials involving over 7,000 patients hospitalized for COVID-19.

After thoroughly reviewing this evidence, the WHO GDG expert panel, which includes experts from around the world including four patients who have had COVID-19, concluded that remdesivir has no meaningful effect on mortality or on other important outcomes for patients, such as the need for mechanical ventilation or time to clinical improvement.

The recommendation is part of a living guideline developed by the WHO with the MAGIC Evidence Ecosystem Foundation. Living guidelines are useful in fast moving research areas like COVID-19 because they allow researchers to update previously vetted and peer-reviewed evidence summaries as new information becomes available, the experts said.

Remdesivir has received worldwide attention as a potentially effective treatment for severe COVID-19 and is increasingly used to treat patients in hospital. Its role in clinical practice has remained uncertain, the experts said.

The panel acknowledged that the certainty of evidence is low and said the evidence did not prove that remdesivir has no benefit. Rather, there is no evidence based on currently available data that it does improve important patient outcomes. Given the remaining possibility of important harm, as well as the relatively high cost and resource implications associated with remdesivir as it must be given intravenously, the experts said they judged this to be an appropriate recommendation.

Additionally, the researchers said they support continued enrolment into trials evaluating remdesivir, especially to provide higher certainty of evidence for specific groups of patients.

They also support continued enrolment into trials evaluating remdesivir, especially to provide higher certainty of evidence for specific groups of patients.

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