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Remdesivir could be promising drug candidate to treat coronavirus

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What is remdesivir?
John Minchillo/AP
ByDr. Chloë E. Nunneley, Sony Salzman, and Dr. Tiffany Kung
April 29, 2020, 11:16 PM

While there are no medications currently approved to treat people with the novel coronavirus, there are several therapies being investigated as potential lifesaving options.

The government announced promising early results Wednesday for one of those treatments -- remdesivir -- now the clear front-runner in the race for a COVID-19 treatment.

The drug, which is still subject to ongoing clinical research, showed promising early results in a government-sponsored trial of more than 1,000 seriously ill and hospitalized patients. It was a randomized, placebo controlled trial -- considered the gold standard in medical science. Although the results are preliminary, the nation's top infectious disease doctor, Anthony Fauci, a member of the White House coronavirus task force, said he felt an ethical imperative to share the promising data publicly, before the traditional peer-review process.

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As for those results, patients who received remdesivir got better after about 11 days, on average, while people who did not receive the drug recovered more slowly -- about 15 days.

"We’ve been eagerly awaiting the results of this US study funded by the NIH. It is very exciting that there may be an antiviral medication that could [show] clinical improvements and affect patient outcomes in a safe way," said Dr. Christopher Seymour, a critical care physician and associate professor of critical care medicine and emergency medicine at the University of Pittsburgh School of Medicine.

But a lesser-known study from China revealed less-promising news about remdesivir. Published Wednesday in the medical journal Lancet, this study did not find a clear benefit for patients who were given the drug. However, the Chinese study was stopped early, reducing the amount of meaningful data that experts can use to form conclusions.

Remdesivir is not approved or licensed anywhere in the world, and experts are still awaiting complete data before concluding if the therapy is proven.

Bottles of Remdesivir in a hospital for COVID-19 for patients in Wuhan, China, Feb. 12, 2020.
Yuan Zheng/FEATURECHINA via Newscom

Remdesivir, which is delivered through an intravenous infusion, was initially developed by the pharmaceutical company Gilead Sciences to treat Ebola. Although initially promising, it didn't prove as effective as other Ebola treatments, so research was halted.

However, laboratory studies found remdesivir might work against SARS, a close cousin to the virus that has caused the current COVID-19 pandemic. Because of its promise, governments around the world acted quickly to set up formal studies to answer the question: Does remdesivir help patients with COVID-19 get better faster?

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In early February, the Chinese government launched a randomized-controlled trial -- considered the gold standard for research. Later that month, another randomized controlled trial sponsored by the United States National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, began at the University of Nebraska Medical Center in Omaha.

The first volunteer to participate in the trial was a passenger of the Diamond Princess cruise ship that was quarantined in Japan in March.

A laboratory technician prepares COVID-19 patient samples for semi-automatic testing at Northwell Health Labs, March 11, 2020, in Lake Success, N.Y.
John Minchillo/AP

Two subsequent multicenter studies were launched in March by Gilead, the company that makes remdesivir. Those studies are slated to enroll approximately 1000 patients, and should be complete by May 2020.

There are now more than 10 studies looking into this drug.

Outside of these clinical trials, some patients have received remdesivir through the U.S. government's "compassionate use" program, which President Donald Trump says his administration is hoping to expand so even more people can access the experimental therapy.

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Though only isolated reports, the handful of patients who have been given the drug through the compassionate use program seemed to get better, raising hope that remdesevir may prove effective in a formal study.

With a vaccine to prevent COVID-19 at least one year away, remdesivir remains one of the most promising drugs to help people already infected with the virus. More time is needed before the medical community can confidently conclude that remdesivir can and should be used in patients with COVID-19, but scientists remain hopeful.

Dr. Delaram Taghipour, a preventive medicine resident at Johns Hopkins Bloomberg School of Public Health and contributor to the ABC News Medical Unit, assisted in this report.

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