Houston Chronicle

» FDA approves emergency use of new drug against COVID-19.

Remdesivir can be used in hospitals for emergency cases

- By Matthew Perrone and Marilynn Marchione

WASHINGTON — U.S. regulators Friday allowed emergency use of the first drug that appears to help some COVID-19 patients recover faster, a milestone in the global search for effective therapies against the coronaviru­s.

The Food and Drug Administra­tion said in a statement that Gilead Sciences’ intravenou­s drug would be specifical­ly indicated for hospitaliz­ed patients with “severe disease,” such as those experienci­ng breathing problems requiring supplement­al oxygen or ventilator­s.

President Donald Trump announced the news at the White House alongside Gilead CEO Daniel O’Day and FDA Commission­er Stephen Hahn.

“This was lightning speed in terms of getting something approved” said Hahn, calling the drug “an important clinical advance.”

The FDA acted after preliminar­y results from a government­sponsored study showed that the drug, remdesivir, shortened the time to recovery by 31 percent, or about four days on average, for hospitaliz­ed COVID-19 patients.

The study of 1,063 patients is the largest and most strict test of the drug and included a comparison group that received just usual care so remdesivir’s effects could be rigorously evaluated.

Those given the drug were able to leave the hospital in 11 days on average, vs. 15 days for the comparison group. The drug may also help avert deaths, but the effect is not yet large enough for scientists to know for sure.

Dr. Sameer Khanijo, a critical care specialist, said he wants to see additional studies to clarify the drug’s benefit.

“I don’t think this is a cure yet, but I think it’s starting to point us in the right direction,” said Khanijo, who’s with North Shore University Hospital in New York. “As a society, it’s nice to have something that will help stem the tide of this disease.”

The FDA said preliminar­y results for federal researcher­s warranted Friday’s decision, though regulators acknowledg­ed that “there is limited informatio­n known about the safety and effectiven­ess of using remdesivir.”

The drug’s side effects include potential inflammati­on of the liver and problems related to its infusion, which could lead to nausea, vomiting, sweating and low blood pressure. Informatio­n about dosing and potential safety issues will be provided to physicians and patients, the FDA said.

The National Institutes of Health’s Dr. Anthony Fauci said Wednesday that the drug would become a new standard of care for severely ill COVID-19 patients. The drug, which blocks an enzyme the virus uses to copy its genetic material, has not been tested on people with milder illness.

The FDA authorized the drug under its emergency powers to quickly speed experiment­al drugs, tests and other medical products to patients during public health crises.

In normal times, the FDA requires “substantia­l evidence” of a drug’s safety and effectiven­ess, usually through one or more large, rigorously controlled patient studies. But during public health emergencie­s, the agency can waive those standards and require only that an experiment­al drug’s potential benefits outweigh its risks.

Gilead has said it would donate its currently available stock of the drug and is ramping up production to make more. It said the U.S. government would coordinate distributi­on of remdesivir to places most in need of it.

No drugs are approved now for treating the coronaviru­s, and remdesivir will still need formal approval.

The FDA can convert the drug’s status to full approval if Gilead or other researcher­s provide additional data of remdesivir’s safety and effectiven­ess.

The FDA previously allowed narrow use of a malaria drug, hydroxychl­oroquine, for hospitaliz­ed patients who were unable to take part in ongoing studies of the medication. Trump repeatedly promoted it as a possible COVID-19 treatment, but no large high-quality studies have shown that the drug works for that, and it has significan­t safety concerns.

The FDA warned doctors late last month against prescribin­g the drug outside of hospital or research settings because of risks of sometimes fatal heart side effects.

Two small studies published Friday add to concerns about the malaria drug. Critically ill COVID-19 patients given hydroxychl­oroquine were prone to heart rhythm problems, and for many, risks mounted when it was combined with an antibiotic, the studies found.

 ?? Erin Schaff / Getty Images ?? President Donald Trump is joined by Gilead Sciences CEO Daniel O’Day and Vice President Mike Pence in announcing federal regulators’ approval of remdesivir in emergencie­s.
Erin Schaff / Getty Images President Donald Trump is joined by Gilead Sciences CEO Daniel O’Day and Vice President Mike Pence in announcing federal regulators’ approval of remdesivir in emergencie­s.

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