Hospitalized patients with advanced COVID-19 and lung involvement who received remdesivir recovered faster than similar patients who received placebo, according to a preliminary data analysis from a randomized, controlled trial involving 1063 patients, which began on February 21. The trial (known as the Adaptive COVID-19 Treatment Trial, or ACTT), sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is the first clinical trial launched in the United States to evaluate an experimental treatment for COVID-19.
Itâs what Wichita posted upthread.
Preliminary results indicate that patients who received remdesivir had a 31% faster time to recovery than those who received placebo (p<0.001). Specifically, the median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received placebo. Results also suggested a survival benefit, with a mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (p=0.059).
Donât think these are particularly impressive results personally. The median time improvement has an impressive p-value, and itâs nice for hospitals to get rid of people faster, but the improvement in outcomes is very modest.
I donât think I posted that but googled it a few minutes ago and didnât find anything besides all the clickbait aidsfest that has been posted all day. Reading it now.
ETA- 31% reduction in recovery time for people who were going to live anyway seems like it isnât nothing and as noted by others is obviously extremely statistically significant based on p-value. No statistically significant impact on mortality is not good obviously. So basically itâs Tamiflu. And without any asymptomatic testing regime probably worthless. Especially because from my understanding of the previous articles they did not focus on ventilated patients. Like you said Chris that isnât a gamechanger. It might moderately improve outcomes for people with a mildly to moderate symptomatic case but does nothing to solve the real problem which is being on pace for 50,000-60,000 dead Americans a month for months in the near future.
The reduction in mortality was close to reaching significance (p = 0.059 vs significance of p = 0.05) and is more impressive if you restate it in percentage terms, like if I say âit prevented 31% of deathsâ thatâs a different story. Thatâs not proven yet but since it is proven that the drug has antiviral activity, a decent-size decrease in deaths looks likely. Weâll have to wait for further results to see how large that decrease really is.
i mean I donât disagree with you but this plus the already leaked study tends to point to, at best, a slightly positive impact. A slightly positive impact really does not a whole lot to unfuck this situation. It doesnât mean it is nothing, it is something, but this has no chance of being a miracle cure. As cuse has said if we find a handful of things that slightly improved mortality rates that may matter a lot. Two studies that both show no statistically significant impact basically means this thing will not solve the underlying problem.
Earlier today I saw a blurb that a lot of testing resources were being diverted to private labs (qwest and labbermajabby), away from universities and other public resources.
Does anyone have any more information on this #capitalismfirst ?
I disagree wrt statistical significance because itâs kind of dumb how that works anyway. If the p-value were 0.049, the headlines would all be âPROVEN TO REDUCE MORTALITYâ but since itâs 0.059, weâre not allowed to say that even though the results were near-identical. It would be better to talk about significance in a less binary way. In this instance, since improvement in recovery secondary to antiviral activity was easily proven, odds are overwhelmingly high that the reduction in mortality is real. The effect size is still in question. A reduction of one third in deaths would be nothing to sneeze at, particularly if the drug turns out to be most effective in younger patients.
It def seems like itâs more of a stop the infection early type drug- not so much late stage. Not uncommon with antivirals as much of the damage is often cytokine storms or other ways your own immune system kills you while trying to kill the virus. Keep the viral counts low and keep the real bad viral atttack and immune system overreaction at bay.
Where I disagree is that if you have two studies and they are
Study 1: mostly(or at least a significant portion)vented patients. Remisdivir is found to not statistically significantly help on either recovery or mortality. And;
Study 2: mostly unvented patients and you find it lowers recovery time with extremely significant p-value but does not lower mortality with statistical significance but P-value is close to significant then;
You can start to draw some conclusions. Mostly what Dan is saying which is the earlier you catch it the better for everything. In a country where testing is still hard to come by in some places and slow to get results in a lot of places I donât see how that helps much.
It seems like a pairing of heavy testing+remisdivir might work(Worked in SK) but that is a pipe dream here.
Maybe Iâm just feeling optimistic today but that Remdesivir study seems like very, very good news to me.
No, itâs not a miracle cure, but itâs pretty damn helpful on its own AND it should portend good things are coming. Scientists should be able to learn from it and figure out what worked. Remdesivir wasnât made for coronavirus, so maybe they can tweak it or come up with something from scratch using the same mechanism with coronavirus more directly in mind.
Definitely hope Remdesivir is for real. The sarcastic jerk within points out that simply participating in the study seems to be correlated with a big improvement in mortality (11.8% compared with ~20% of hospitalized folks apparently) but who knows.
I mean it basically doesnât work for Coronavirus but it might make your symptoms less horrible if you catch it early enough which I agree is a pretty big deal. It is the first meaningful test of any kind that shows effectiveness of any drug towards Covid-19.
Of course the next problem is they canât ramp up to more than a small number of doses anytime that soon even if it works.
The link from a few posts ago wasnât the full study and I agree how they chose the subjects matters a lot. We already know they basically didnât choose the sickest patients which is an obvious problem when we are talking about the worst impacts.
Seems like the Remdesivir results are probably somewhere between helps a bit and helps quite a bit. Iâll take it - seems strictly better than spraying Lysol up my butt or drinking fish bowl cleaner.
Itâs promising in the sense that, if we could ever get testing up to scale, maybe it would be much more effective given to people who are presymptomatic or just starting to show symptoms. Tamiflu is really only effective if administered within the first 24 hours of showing symptoms. One could hypothesize that this drug could be similar and could be REALLY helpful in preventing bad outcomes if administered as soon as somebody shows symptoms, or even better, if we are testing randomly enough so that somebody who is presymptomatic can be administered the drug. Obviously weâre not there yet, but thatâs why this is promising.
I think I had suggested earlier if it is effective early then hi risk for serious Covid should get in the hospital. That IV part is really limiting for tamiflu like use.
FYI- I worked on production of one of the intermediates in tamiflu. The strain group make us a nice strain and I scaled it up to make the first 100 kg roughly. All in a little over 6 months. Before I left the company we lost out as supplier because the Chinese were literally solvent extracting the compound from a fruit and then spreading the solvent out on to a cement pad and letting the sun drive off the solvent. We were pissed.
I found later that the buyer came back and my old group ended up making thousands of kgs by the fermentation process. Apparently in big batches the Chinese product had some serious quality issues. Who would have guessed that.