Read on Twitter
Many of us are 
about the news that remdesivir may not, actually, change mortality for #COVID19.
Why?
https://www.nytimes.com/2020/10/15/health/coronavirus-remdesivir-who.html @KatherineJWu @ginakolata
about the news that remdesivir may not, actually, change mortality for #COVID19. Why?
https://www.nytimes.com/2020/10/15/health/coronavirus-remdesivir-who.html @KatherineJWu @ginakolata
First: a prior series of articles about remdesivir in @NEJM - including one from 10/8 - suggest at best, minimal effects of this drug. It may decrease time to recovery... but also, may not. No effect on mortality.
So this result is not surprising. https://www.nejm.org/doi/full/10.1056/NEJMoa2007764
So this result is not surprising. https://www.nejm.org/doi/full/10.1056/NEJMoa2007764
Second: the new preprint SOLIDARITY study was HUGE, but also included a number of other treatments, and a wide heterogeneity of healthcare systems & standards.
So despite its great statistical power, it has limitations, which stop us from "throwing the baby out."
So despite its great statistical power, it has limitations, which stop us from "throwing the baby out."
Third: Like the NEJM studies, this study gave remdesivir to the sickest patients.
Some suspect that it may be more effective in LESS sick patients - those who have not yet experienced the immunologic over-reaction that causes the worst symptoms of #COVID19.
Some suspect that it may be more effective in LESS sick patients - those who have not yet experienced the immunologic over-reaction that causes the worst symptoms of #COVID19.
..... At the end of the day, to many of us, this feels similar to oseltamavir (aka Tamiflu), which may/may not actually help in severe flu, but which we give anyhow, because we have no good alternatives https://www.center4research.org/tamiflu-not-tamiflu/
We worry that this is a medication in search of a use.... and that we are all so desperate for a treatment, that we'll take the smallest signals of efficacy and run with it.
/ fin
/ fin
