Itsallaguess wrote:redsturgeon wrote:
There's a lot of hope and expectation out there which can cloud judgement.
Of course, but it would seem to be an odd approach to this issue if we were to collectively ignore one of the few treatments to have a positive effect on this virus, and to do so at such a crucial stage of infection, where cutting timescales of any sort is likely to be critical to the outcome of some patients taking the treatment, and other patients potentially waiting for beds or ventilators....
Someone said early on in the outbreak that we were 'in the foothills' of the current wave of the pandemic, and clearly the same could also be said about the development of treatments for it, but surely it's treatments such as this that can at the very least help to provide a pathway
through those foothills, and on to better, and more thorough and broader medicines?
I just find it a bit strange that you seem to think that the wider use of this particular treatment is such a negative thing to be doing, and that it's likely to affect other treatments 'getting support'.
Such is the huge global scientific effort in tackling this thing, I would find that simply astonishing if it were true...
If we were on another board, I'd probably ask if Gilead being a US company is influencing your view on this particular treatment at all, but that's probably a topic that's best left for the other place..
Cheers,
Itsallaguess
I'm not suggesting we should ignore this drug or any of the others being looked at but we try to keep things in perspective. This drug is not and can never be the silver bullet. The best we can hope is for some shortening of hospital stay.
Here is the earlier study from China published in the Lancet
https://www.thelancet.com/journals/lanc ... 9/fulltext
Between Feb 6, 2020, and March 12, 2020, 237 patients were enrolled and randomly assigned to a treatment group (158 to remdesivir and 79 to placebo); one patient in the placebo group who withdrew after randomisation was not included in the ITT population. Remdesivir use was not associated with a difference in time to clinical improvement (hazard ratio 1·23 [95% CI 0·87–1·75]). Although not statistically significant, patients receiving remdesivir had a numerically faster time to clinical improvement than those receiving placebo among patients with symptom duration of 10 days or less (hazard ratio 1·52 [0·95–2·43]). Adverse events were reported in 102 (66%) of 155 remdesivir recipients versus 50 (64%) of 78 placebo recipients. Remdesivir was stopped early because of adverse events in 18 (12%) patients versus four (5%) patients who stopped placebo early.
My experience in the industry over many years has shown me that there are many ways to both design, manage and interpret clinical trials results to give you the outcome that you desire. All I am doing is suggesting caution in the interpretation of one study.
I have nothing against the fact that Gilead is a US company, in fact one of our biggest customers is a large US pharmco for whom I have nothing but respect and whose ethics I consider at least on a par with the UK company I worked for over many years. I would be posing the same caveats no matter what nationality Gilead was. On the other hand I would suggest it doubtful that a non US company would have received FDA approval quite as quickly.
I see the use of remdesivir in a similar light to Tamiflu from Roche, which shortens flu symptoms by a day or so but at a significant cost and with potential side effects in some patients. On a cost benefit analysis it is a close call.
If you have a drug that suddenly everyone wants to use then there is little doubt in my mind that some effect will be created that limits the availability of patients for testing with other medications since once someone is being treated with remdesivir they would not be eligible for a study of another drug except in combination.
I hope that the current research continues apace with all potential candidates being studied and fully funded. Sometimes though overhyping in this field can have knock on effects (see shortages of hydroxychloroquine cause by Trump's tweets), see also
https://www.healio.com/infectious-disea ... y-covid-19
John