Remdesivir Use in the Real-World Setting: An Overview of Available Evidence

Abstract

In the years of Coronavirus Disease 2019 (COVID-19), various treatment options have been utilized. COVID-19 continues to circulate in the global population, and the evolution of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has posed significant challenges to the treatment and prevention of infection. Remdesivir (RDV), an anti-viral agent with in vitro efficacy against coronaviruses, is a potent and safe treatment as suggested by a plethora of in vitro and in vivo studies and clinical trials. Emerging real-world data have confirmed its effectiveness, and there are currently datasets evaluating its efficacy and safety against SARS-CoV-2 infections in various clinical scenarios, including some that are not in the SmPC recommendations according for COVID-19 pharmacotherapy. Remdesivir increases the chance of recovery, reduces progression to severe disease, lowers mortality rates, and exhibits beneficial post-hospitalization outcomes, especially when used early in the course of the disease. Strong evidence suggests the expansion of remdesivir use in special populations (e.g., pregnancy, immunosuppression, renal impairment, transplantation, elderly and co-medicated patients) where the benefits of treatment outweigh the risk of adverse effects. In this article, we attempt to overview the available real-world data of remdesivir pharmacotherapy. With the unpredictable course of COVID-19, we need to utilize all available knowledge to bridge the gap between clinical research and clinical practice and be sufficiently prepared for the future.

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“…The first FDA-approved antiviral treatment, remdesivir (Gilead ® ), is being safely used in elderly adults, pediatric populations, and patients with hereditary hyper-coagulopathies or thrombophilia [162][163][164]. The oral treatment molnupiravir (Merck ® ) was found to be effective in the pre-hospitalization stage of COVID-19 [165].…”

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“…the establishment of anti COVID-19 indications for existing drugs, was adopted since the beginning of the pandemic (see for example "The WHO Solidarity PLUS Trial"https://acesse.dev/E8tdP -retrieved February 2024). Even though in most of cases the search for pharmacological alternatives for treating infected patients has focused in the evaluation of the clinical efficacy of antiviral agents already approved (with some successful examples, (Akinosoglou et al, 2023;Gudima et al, 2023;Hammond et al, 2022), the assessment of some "non-antiviral" drugs has also been conducted (Xue et al, 2023). In this context, a recent study using human-SARS-CoV-2 interactome data and network pharmacology, allowed the identification of some human targets (e.g.…”

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“…Emerging real-world data has confirmed its effectiveness, and datasets currently exist evaluating its efficacy and safety against SARS-CoV-2 infections in various clinical scenarios. Remdesivir increases the chances of recovery, reduces progression to severe disease, lowers mortality rates and shows beneficial post-hospitalization results, especially when used in the early stages of the disease [ 2 ].…”