WHO expert panel advises against use of remdesivir for hospitalised COVID-19 patients

A World Health Organization (WHO) Guideline Development Group (GDG) says “the antiviral drug remdesivir is not suggested for patients admitted to hospital with COVID-19, regardless of how severely ill they are”. The panel of experts added that this is because there is currently no evidence that it improves survival or the need for ventilation.

The recommendation is part of a living guideline developed by WHO to provide trustworthy guidance on the management of COVID-19. Living guidelines are summaries based on previously vetted and peer reviewed evidence.

Remdesivir has received a lot of attention as a potential treatment for severe COVID-19 during the pandemic and has been approved for emergency use in the US and UK, as well as granted conditional marketing authorisation by the European Medicines Agency (EMA).

However, the WHO GDG say its role in clinical practice has remained uncertain and based on a new evidence review, comparing the effects of several drug treatments for COVID-19, it concluded that remdesivir has no meaningful effect on mortality or on other important outcomes for patients, such as the need for mechanical ventilation or time to clinical improvement. The data they reviewed was taken from four international randomised trials involving over 7,000 patients hospitalised for COVID-19.

The panel did acknowledge that the evidence did not prove that remdesivir has no benefit. However, the possibility of remdesivir causing harm, as well as the relatively high cost and resource implications associated with the drug (eg, intravenous administration) meant they could not recommend it.

The group concluded that they support the continued enrolment of patients into trials evaluating remdesivir, especially to provide higher certainty of evidence for specific groups of patients.