Remdesivir: A Review in COVID-19

Remdesivir (Veklury(& REG;)), a nucleotide analogue prodrug with broad-spectrum antiviral activity, is approved for the treatment of coronavirus disease 2019 (COVID-19), the illness caused by severe acute respiratory syndrome coronavirus 2 infection. Unlike some antivirals, remdesivir has a low potential for drug-drug interactions. In the pivotal ACTT-1 trial in hospitalized patients with COVID-19, daily intravenous infusions of remdesivir significantly reduced time to recovery relative to placebo. Subsequent trials provided additional support for the efficacy of remdesivir in hospitalized patients with moderate or severe COVID-19, with a greater benefit seen in patients with minimal oxygen requirements at baseline. Clinical trials also demonstrated the efficacy of remdesivir in other patient populations, including outpatients at high risk for progression to severe COVID-19, as well as hospitalized paediatric patients. In terms of mortality, results were equivocal. However, remdesivir appeared to have a small mortality benefit in hospitalized patients who were not already being ventilated at baseline. Remdesivir was generally well tolerated in clinical trials, but pharmacovigilance data found an increased risk of hepatic, renal and cardiovascular adverse drug reactions in the real-world setting. In conclusion, remdesivir represents a useful treatment option for patients with COVID-19, particularly those who require supplemental oxygen. Plain Language SummaryCoronavirus disease 2019 (COVID-19) was first reported in China in 2019 and quickly spread around the world. The symptoms of COVID-19 can vary from person to person, with some people having no symptoms and others becoming very unwell. Most patients with COVID-19 can treat their symptoms at home, but some patients may be admitted to hospital and/or treated with specialized medications such as remdesivir (Veklury(& REG;)). Remdesivir is an antiviral medicine that can reduce the amount of virus that causes COVID-19. It is given once a day, usually for 5-10 days, as an intravenous infusion. Remdesivir has been shown to improve the recovery time in hospitalized patients with COVID-19, including children and adolescents. It may also reduce the risk of death in hospitalized patients who are not being ventilated before they start treatment. A 3-day course of remdesivir is also effective in patients whose age or underlying health puts them at high risk for becoming severely ill. The drug is generally well tolerated. Therefore, remdesivir is a useful treatment option for patients with COVID-19, especially those who require additional oxygen.