There is new information available since the writing of this article: Gilead antiviral drug remdesivir flops in first trial

Remdesivir and Favipiravir are our best hope at the present time

Written and collected by Zia H Shah MD, Chief Editor of the Muslim Times

At the root of development of medicine in the last few centuries are controlled studies, where anecdotes of one cure or one good result is not given a lot of significance as that can happen by chance and there is a cliche, “One mouse is no mouse!”

So, standard wisdom in medicine is that a group of patients is given a particular medicine and the other group is given an inert substance in place of the medicine, or fake medicine if you will.  This second group is called the control group.  Statistical methods are then applied to the two groups and the efficacy of the medicine is judged in this scientific setting rather than a few good outcomes or expert opinion or gut feeling about a medicine.

This is called objective data as opposed to gut feeling, personal opinion or bias.

Since the start of the pandemic in China in November of last year the world is looking for a cure, for a panacea if you will.

Among the promising candidates are Remdesivir and Favipiravir. But to date the controlled studies available for these are rather limited, but we have a lot of additional information about them at the present time.

In face of the 185,000 deaths due to the pandemic worldwide, we need to make the best possible decision today and not tomorrow to save additional lives.

The best and the most accurate science will come in due course of time but we need the best possible decision today in face of what we know today.

This is what this article is about.

CNN reported on April 22: Nearly all Covid-19 patients put on ventilators in New York’s largest health system died, study finds. It stated that nearly all coronavirus patients who needed ventilators in New York’s largest health system to help them breathe died, a study found.

Overall, about 20% of Covid-19 patients treated at Northwell Health died, and 88% of those placed on ventilators died, according to the study. A ventilator is a device that forces air into the lungs of patients who cannot breathe on their own because of severe pneumonia or acute respiratory distress syndrome.

Other, smaller reports have indicated that patients who need ventilation are unlikely to survive.

Just 12% of the patients in the study needed ventilators, Dr. Safiya Richardson at the Feinstein Institutes for Medical Research, Northwell Health, and colleagues found.

The team looked at the electronic health records of 5,700 patients with coronavirus disease hospitalized at Northwell Health. Final outcomes were known for 2,634 of them.

But this study, published in the Journal of the American Medical Association, shows how dire the outlook is for patients with severe Covid-19 disease.

When we contrast the results from Remdesivir and Favipiravir against the dire picture reported from New York city then we have strong and clear reasons to celebrate.  This is what in science we call comparison against historical controls rather than a more precise and scientific control in the population or group under study.

The University of Chicago Medicine recruited 125 people with Covid-19 into Gilead’s two Phase 3 clinical trials. Of those people, 113 had severe disease. All the patients have been treated with daily infusions of remdesivir.

“The best news is that most of our patients have already been discharged, which is great. We’ve only had two patients perish,” said Kathleen Mullane, the University of Chicago infectious disease specialist overseeing the remdesivir studies for the hospital.

Her comments were made this week during a video discussion about the trial results with other University of Chicago faculty members. The discussion was recorded and STAT obtained a copy of the video. Read further: Early peek at data on Gilead coronavirus drug suggests patients are responding to treatment.

A controlled study in monkeys showed very remarkable results in the six monkeys that receive the real medicine: Antiviral remdesivir prevents disease progression in monkeys with COVID-19, in a controlled trial.

Preliminary data from two clinical trials using the antiviral drug remdesivir to treat COVID-19 patients is encouraging, researchers report.

One trial is providing the drug to patients with moderate illness and the other focuses on patients with severe illness.

A number of the patients are now recovering and have been released from the hospital. While it’s too early to tell, the researchers said there are also indications that remdesivir can possibly stave off being put on a ventilator.

“Early results are promising, and that is important right now. Much of what we are learning about COVID-19 management is centered around preventing quick deterioration. Timing is everything. I can’t say for certain they [patients] would have been intubated otherwise, but it’s encouraging,” said Katherine Perez, an infectious diseases pharmacist who is co-leading the trials.

Houston Methodist Hospital was the fifth site in the United States to join the clinical trials with remdesivir, and it began enrolling and treating patients in mid-March.  For additional details please go to: More Good News on Remdesivir’s Power to Treat COVID-19.

Avigan also known as favipiravir, was approved for use in Japan in 2014 for influenza. It is being tested in China as a treatment for COVID-19.

Medical authorities in China have said a drug used in Japan to treat new strains of influenza appeared to be effective in Coronavirus patients.

Zhang Xinmin, an official at China’s science and technology ministry, said favipiravir, developed by a subsidiary of Fujifilm, had produced encouraging outcomes in clinical trials in Wuhan and Shenzhen involving 340 patients.

Patients who were given the medicine in Shenzhen turned negative for the virus after a median of four days after becoming positive, compared with a median of 11 days for those who were not treated with the drug, Japan public broadcaster NHK said last month.

In addition, X-rays confirmed improvements in lung condition in about 91% of the patients who were treated with favipiravir, compared to 62% or those without the drug. For reference and additional details please go to: Cyprus among 20 countries to get Avigan anti-flu drug, for Covid 19 patients.

Numerous other studies have shown that early treatment is the key in treating patients with Covid 19.

We also know that half those who get infected with Covid 19 are asymptomatic and another 30-35% have only very mild symptoms.

I am urging that these medicines should be made urgently available for the 15% who have significant lung symptoms like more than mild cough, high grade fever or difficulty in breathing.  By so doing we are likely to prevent patients from getting on the ventilator and save lives.

Japan is being generous and making Avigan available to several countries.  One would hope that charitable organizations like the Clinton Foundation and Bill & Melinda Gates Foundation will make Remdesivir available worldwide also, until good vaccines become a reality.

The Gates Foundation homepage states: “All lives have equal value, we are impatient optimists working to reduce inequity.” Let us make sure that this medicine becomes available for everyone rather than a select few, rich and famous celebrities.

As greater and more precise information becomes available we can fine tune the planning.

Please help make the worldwide availability of these drugs a reality to save lives, by clicking away and sharing this post, one click at a time. Who knows you may need the medicine for yourself or your loved one?

May God be with you and stay safe!