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All Studies   Meta Analysis    Recent:   

Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results

SOLIDARITY Trial Consortium, NEJM, doi:10.1056/NEJMoa2023184 (date from preprint), SOLIDARITY, NCT04315948
Oct 2020  
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Mortality 5% Improvement Relative Risk Non-ventilated patients 14% Remdesivir  SOLIDARITY  LATE TREATMENT  RCT Is late treatment with remdesivir beneficial for COVID-19? RCT 5,451 patients in multiple countries No significant difference in mortality c19early.org SOLIDARITY Trial Consortium, NEJM, Oct 2020 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
WHO SOLIDARITY open-label RCT with 2,750 very late stage (76% on oxygen/ventilation) remdesivir patients, mortality relative risk RR 0.95 [0.81-1.11], p=0.50. Non-ventilated patients show a greater benefit, RR 0.86 [0.72-1.04], p = 0.13.
Gérard, Zhou, Wu, Kamo, Choi show significantly increased risk of acute kidney injury with remdesivir.
Remdesivir efficacy disappears with longer followup. Mixed-effects meta-regression of efficacy as a function of followup duration across all remdesivir studies shows decreasing efficacy with longer followup6. This may reflect antiviral efficacy being offset by serious adverse effects of treatment.
Followup duration (days) Efficacy Remdesivir mortality efficacy decreases with longer followup 0 15 30 45 60 75 90 105 -25% 0% 25% 50% c19early.org October 2024 mixed-effects meta-regression slope -0.58 [95% CI -0.92 to -0.24] p=0.00089
Study covers remdesivir and HCQ.
risk of death, 5.0% lower, RR 0.95, p = 0.53, treatment 301 of 2,743 (11.0%), control 303 of 2,708 (11.2%), NNT 464, day 28.
non-ventilated patients, 14.0% lower, RR 0.86, p = 0.13, day 28.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
SOLIDARITY Trial Consortium et al., 15 Oct 2020, Randomized Controlled Trial, multiple countries, peer-reviewed, 15 authors, trial NCT04315948 (history) (SOLIDARITY).
This PaperRemdesivirAll
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.10.15.20209817.this version posted October 15, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. 1 MedRxiv (October 15) version Repurposed antiviral drugs for COVID-19 –interim WHO SOLIDARITY trial results WHO Solidarity trial consortium* *A complete list of SOLIDARITY Trial investigators is provided in the Supplementary Appendix. Hongchao Pan, Ph.D., Richard Peto, F.R.S., Quarraisha Abdool Karim, Ph.D., Marissa Alejandria M.D., M.Sc., Ana Maria HenaoRestrepo, M.D., M.Sc., César Hernández García M.D., Ph.D., Marie-Paule Kieny Ph.D., Reza Malekzadeh M.D., Srinivas Murthy M.D. C.M., Marie-Pierre Preziosi M.D., Ph.D., Srinath Reddy M.D., D.M., Mirta Roses Periago M. D., Vasee Sathiyamoorthy B.M.B.Ch., Ph.D., John-Arne Røttingen M.D., Ph.D., and Soumya Swaminathan M.D. , as the members of the Writing Committee, assume responsibility for the content and integrity of this article. International Steering Committee *National PI; †National Coordinator; ‡Executive Group;§Discovery add-on study. Albania: University Hospital Centre, Tirana N Como*; National Agency for Medicines and Medical Devices N Sinani†. Argentina: Fundación del Centro de Estudios Infectológicos G Lopardo*; National Academy of Sciences of Buenos Aires M Roses Periago†‡. Austria:§. Belgium:§. Brazil: Oswaldo Cruz Foundation EP Nunes*, PPS Reges†. Canada: University of British Columbia S Murthy*‡; Public Health Agency of Canada M Salvadori†. Colombia: National University of Colombia CA Alvarez- Moreno*; Ministry of Health ML Mesa Rubio†. Egypt: National Hepatology and Tropical Medicine Research Institute M Hassany*; Ministry of Health and population H Zaid†. Finland: Helsinki University Hospital and South Karelian Central Hospital, Lappeenranta KAO Tikkinen*; Finnish Institute for Health and Welfare and University of Finland, Helsinki M Perola†. France: Hospices Civils de Lyon, Lyon F Ader*§; Institut National de la Santé Et de la Recherche Médicale, Paris MP Kieny†‡§. Honduras: National Autonomous University of Honduras MT Medina*; Secretaria de Salud de Honduras N Cerrato†. India: ICMR National AIDS Research Institute, Pune S Godbole*†; Public Health Foundation of India KS Reddy‡. Indonesia: National Institute of Health Research and Development I Irmansyah*; RSUP Persahabatan, Jakarta MR Rasmin†. Iran (Islamic Republic of): Digestive Disease Research Institute, Teheran University of Medical Sciences, Tehran R Malekzadeh*†‡. Ireland: HRB Clinical Research Facility, University College, Cork J Eustace*; Department of Health T Maguire†. Italy: University of Verona E Tacconelli*; Italian Medicines Agency N Magrini†. Kuwait: Infectious Diseases Hospital A Alhasawi*; Ministry of Health A Al-Bader†. Lebanon: Rafic Hariri University Hospital P Abi Hanna*; Ministry of Public Health R Hamra†. Luxembourg:§. Lithuania: University Hospital Santaros klinikos, Vilnius L Jancoriene*, L Griskevicius†. Malaysia: Penang Hospital TS Chow*; Hospital Sungai Buloh, Jalan Hospital S Kumar†. North Macedonia: University Clinic of Infectious Diseases and Febrile Conditions M Stevanovikj*; Ministry of Health S Manevska†. Norway: Oslo University Hospital P Aukrust*, A Barratt-Due†; Research Council of Norway JA Røttingen‡. Pakistan: Shaukat Khanum Memorial Cancer..
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Late treatment
is less effective
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