Patients rush to join studies on promdes coronavirus drug remdesivir

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The new coronavirus has made Dr. Jag Singh a patient in his own hospital. His alarm went up when he saw an x-ray of his lungs clogged with pneumonia, and his colleagues asked him about his wishes for survival while he rolled him into the intensive care unit of Massachusetts General.

When they offered him the opportunity to test remdesivir, an experimental drug that has shown promise against some other coronaviruses, it “didn’t even cross my mind once to say” no “”, said Singh, heart specialist.

Coronavirus patients around the world are rushing to join the remdesivir studies that have started in hospitals in recent weeks.

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The interest has been so great that the National Institutes of Health in the United States is expanding their study, which has almost met its original target of 440 patients. California-based drug maker Gilead Sciences is also rapidly ramping up its own studies.

“I would enlist my family in the blink of an eye” if the need arose, said Dr. Libby Hohmann, who placed Singh and nearly 30 others in the NIH at General Mass. Not having COVID-19 approved drugs now is “a little terrifying,” she said.

Remdesivir is administered intravenously. It is designed to interfere with an enzyme that reproduces viral genetic material.

In animal trials of SARS and MERS, diseases caused by similar coronaviruses, the drug helped prevent infection and reduce the severity of symptoms when given early enough during illness . It is more advanced in testing than many other potential therapies and current studies could lead to regulatory approval.

Gilead has administered remdesivir to more than 1,700 patients on a case-by-case basis, but more people will ultimately be helped if the company studies to prove safety and effectiveness, wrote CEO Dan O’Day in a recent letter. to the public.

“Many people have contacted Gilead to advocate for access to remdesivir on behalf of their friends and relatives. I can only imagine what it must be like to feel in this situation, “he wrote. “We take an ethical and responsible approach. “

In another letter on Saturday, O’Day said the company had 1.5 million doses, which could mean more than 140,000 treatment cycles, depending on the length of treatment. The company is providing the drug free of charge at the moment and has set a target of completing 500,000 courses of treatment by October and more than a million by the end of the year.

Gilead has provided remdesivir for two studies in China that are expected to yield results by the end of the month. He also launched two studies for hospital patients in the United States, Asia, Europe and elsewhere. One, in critically ill patients, tests five versus 10 days of treatment. Another, in moderately ill patients, compares these two options to standard care alone.

“There is so much anxiety about the disease that patients are very interested” and no one has offered this chance refused, said Dr. Arun Sanyal, study leader at Virginia Commonwealth University in Richmond .

The first patient he recruited was a previously healthy, middle-aged man who had an out-of-state visitor a few days before his symptoms started. What started out as a mild illness degenerated into a shortness of breath that required additional oxygen.

At University Medical Hospital Cleveland Medical Center, Dr. Grace McComsey has registered approximately half a dozen patients.

“We are seeing more and more young people, like 30, really sick,” she said.

The NIH study is the most rigorous test. He compares remdesivir to placebo infusions, and neither patients nor doctors know who is receiving what until the end of the study. Besides the United States, it is open in Japan, Korea and Singapore.

In Chicago, an 89-year-old man was the first attendee at Northwestern Memorial Hospital and “the family was very excited” to have him included, said Dr. Babafemi Taiwo, chief of infectious diseases.

At the University of California, Irvine, Dr. Alpesh Amin has enrolled several patients. All receive standard care even if they end up getting a placebo rather than remdesivir, Amin said.

Boston cardiologist Singh said he was ready to seize this opportunity to advance science, even if he ended up personally missing out. He is now recovering at home after spending a week in the hospital.

“Some people are afraid of the word” placebo “, but rigorous testing is necessary to avoid giving false hope or using something dangerous. Yet it is difficult to confront patients without proven therapy now, said Hohmann.

“The worst part is seeing very young people who are really, really sick,” like a 49-year-old man with three young children in intensive care, she said. “It’s pretty horrible. “

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