Fresno, California 2020-11-20 06:00:01 –
On Friday, the World Health Organization Guidelines Committee advised inpatients not to use the antiviral remdesivir, with no evidence that it would improve survival or avoid respiratory needs. Said.
However, in the United States and many other countries, the drug has become the standard of care since major government-led studies have found other benefits. The recovery period for inpatients has been reduced from an average of 15 days to 10 days.
In the United States, the Federal Guidelines Committee and some major medical groups have approved two other treatments for emergency use by the Food and Drug Administration: Eli Lilly’s experimental antibody drug and COVID-19 survivor’s blood. We do not approve recovery plasma. The group says there is not enough evidence to agree or disagree with them.
Physicians also remain uncertain when and when to use the only drug known to improve survival in the most ill COVID-19 patients, dexamethasone or similar steroids.
See: COVID patients play the violin and thank healthcare professionals
And things got worse with Thursday’s news that the anti-inflammatory drug tocilizumab might help. As with the major WHO studies on remdesivir, preliminary results on tocilizumab have not yet been published and have not been fully reviewed by independent scientists, leaving doctors uncertain about what to do.
“This is a real headache,” said Dr. Derek Angus of the University of Pittsburgh, who is involved in research testing many of these treatments. “We need to check the details.”
Dr. Rochelle Warrensky, Chief of Infectious Diseases at Massachusetts General Hospital, agreed.
“It’s really hard to practice medicine in a press release,” she said in a podcast with a medical journal editor on Thursday. “I’m really reluctant … what I call that standard treatment” until the National Institutes of Health guidelines approve the treatment.
Angus said there are legitimate questions about all drug studies.
“It’s not uncommon for expert guidelines to disagree with each other, it’s just that they’re all under the microscope of COVID-19,” he said.
The cracks around remdesivir, sold as Veklury by Gilead Sciences Inc., are the most serious. WHO guidelines emphasize that the drug does not save lives, largely based on WHO-sponsored studies that are larger but much less rigorous than US-led studies that have found other benefits. doing.
The WHO panel concluded that the drug was inadequately selected because it was given by infusion for about 5 days, was expensive, and had no “meaningful effect” on mortality.
Gilliad charges $ 3,120 for a general course of treatment for patients with private insurance and $ 2,340 for those covered by government health programs in the United States and other developed countries. In poor and middle-income countries, much cheaper versions are sold by generic manufacturers.
This week, the Institute for Clinical Economic Review, a non-profit organization that analyzes drug prices, said Remdecibir will price about $ 2,470 for inpatients with moderate to severe illness to reduce costs due to shorter treatment days. I said it needs to be set. However, the group concluded that it was worth only $ 70 for patients hospitalized for mild illness.
Prices may also be driving a decline in demand. In October, U.S. health officials said hospitals purchased only about one-third of the dose of remdesivir provided in the past few months when the drug was scarce. Between July and September, state and local health departments had access to 500,000 treatment courses, but only about 161,000 were purchased.
In another development, on Thursday the FDA urgently licensed the use of baricitinib, another anti-inflammatory drug used with remdesivir. In one study, the addition of baricitinib reduced the average time to recovery of critically ill inpatients by an additional day.
Lily is currently selling baricitinib as an olmiant for the treatment of rheumatoid arthritis. Rheumatoid arthritis is a less common form of arthritis that occurs when a false or overreacted immune system attacks a joint and causes inflammation. An excessive immune system can also cause serious problems in coronavirus patients.
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WHO panel advises against remdesivir treatment for COVID-19 Source link WHO panel advises against remdesivir treatment for COVID-19