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What is remdesivir, and can it help stop the spread of coronavirus?

The Health Secretary, described the drug as “probably the biggest step forward in the treatment of coronavirus since the crisis begun” - REUTERS
The Health Secretary, described the drug as “probably the biggest step forward in the treatment of coronavirus since the crisis begun” - REUTERS
Coronavirus Article Bar with counter
Coronavirus Article Bar with counter

Remdesivir has been approved as the first drug to treat Covid-19 in the UK, the Department of Health has said.

Matt Hancock, the Health Secretary, described the drug as “probably the biggest step forward in the treatment of coronavirus since the crisis begun”.

Early data from clinical trials around the world showed remdesivir could shorten the recovery time of Covid-19 patients by up to four days.

But what is it, how does it work and who will it be given to?

What is it remdesivir?

Remdesivir is an antiviral drug that was developed to tackle Ebola, by biopharmaceutical company Gilead Sciences.

The drug is administered intravenously to patients in hospital.

Although it did not prove as effective against Ebola as hoped, it was later discovered to be promising against SARS, which is also caused by coronavirus, so it’s developers expected it would also be effective against Covid-19.

The Medicines and Healthcare products Regulatory Agency (MHRA) has now cleared the treatment to be used as part of the Early Access to Medicines Scheme (EAMS) in the UK.

Remdesivir is approved to treat Covid-19 in UK - Ulrich Perrey/Pool via REUTERS
Remdesivir is approved to treat Covid-19 in UK - Ulrich Perrey/Pool via REUTERS

How does it work?

When Covid-19 enters a human cell it reproduces with the aid of a viral enzyme.

Remdesivir blocks the virus from creating copies of itself  by “causing profound disruption” to that process, as Dr Stephen Griffin, Associate Professor in the School of Medicine, University of Leeds, said. 

“Unlike many similar available antiviral drugs, remdesivir is also relatively unaffected by one of the safeguarding proteins that the virus uses to prevent this from happening, further boosting its importance for Covid-19,” he explained.

What have the remdesivir trials shown so far?

Earlier this month, a global clinical trial, which is continuing, found that remdesivir cut the length of time people suffered symptoms from 15 days to 11.

The trial involves around 1,000 patients from hospitals including the UK, US, France, Italy and China.

Innovation Minister Lord Bethell said: "This shows fantastic progress. As we navigate this unprecedented period, we must be on the front foot of the latest medical advancements, while always ensuring patient safety remains a top priority.

"The latest expert scientific advice is at the heart of every decision we make, and we will continue to monitor remdesivir's success in clinical trials across the country to ensure the best results for UK patients."

The Respiratory Clinical Trials Unit in Hull is one of the centres which runs a trial of remdesivir.

"As we navigate this unprecedented period, we must be on the front foot of the latest medical advancements, while always ensuring patient safety remains a top priority," James Bethell,  junior health minister, said.

"We will continue to monitor remdesivir’s success in clinical trials across the country to ensure the best results for UK patients."

The US National Institutes of Health (NIH) said last week that data from its trial of remdesivir showed that the drug offers the most benefit for Covid-19 patients who need extra oxygen but do not require mechanical ventilation.

The researchers also said that "given high mortality despite the use of remdesivir," it is likely that the drug would be more effective in combination with other treatments for Covid-19, the respiratory illness caused by the coronavirus.

What are the side effects?

In a clinical trial of remdesivir by the drugs creators, Gilead, the most comment side effects were nausea and acute respiratory failure.

High liver enzymes, which could indicate liver damage, occurred in 7.3 per cent of patients, and 3 per cent of patients stopped using the drug due to these elevated liver tests.

Which patients will it be given to?

Before now, doctors could not provide remdesivir to patients outside of trials as they did not have regulatory approval.

The drugs regulator, the MHRA, has said it supports the use of remdesivir as the first medicine to treat coronavirus in the UK.

Dr June Raine, MHRA Chief Executive, said: “We are committed to ensuring that patients can have fast access to promising new treatments for Covid-19.

"We will continue to work closely with the Department of Health and Social Care and other healthcare partners on protecting public health in the UK by prioritising our essential work on clinical trials, access to medicines, and the development of vaccines.”

But the approval of the drug is for “the treatment of adults and adolescent patients hospitalised with suspected or laboratory confirmed Covid-19 infection and severe disease”, meaning it cannot be used for the prevention of disease in patients without Covid-19, Professor Stephen Evans, Professor of Pharmacoepidemiology, London School of Hygiene & Tropical Medicine, said.

It can also not be given to patients under 12.

The Government said that the allocation of the drugs would be determined by where they would have the greatest benefit, but did not say how many patients would be treated under the arrangement.

Prof Evans adds “it’s a little too early to say” if it will become the standard of care for Covid-19 patients.

“The large trials still ongoing should clarify that,” he said.

“Its availability in the UK and elsewhere is not yet clear. Its adverse effect profile is not fully understood, though it seems there are as yet no major concerns.”

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Can remdesivir help stop the spread of coronavirus?

Coronavirus is believed to spread via droplets which land on shared surfaces, people catch the virus when they touch that surface and then their infected hands to their face.

The anti-viral drug, remdesivir, is not designed to prevent the spread of the virus, but to lessen the severity of the symptoms which the virus induces when people become infected.

How promising is the approval of remdesivir?

The news that remdesivir will now be available to patients in the UK is "welcome indeed", said Dr Griffin.

He added that the drug is "the most promising direct-acting antiviral drug in current trials targeting Covid-19".

But he cautioned the drug will not immediately be a "magic bullet".

“Rolling out remdesivir via the EAMS will likely mean that the most severe Covid-19 patients will receive it first.

"Whilst this is clearly the most ethically sound approach, it also means that we ought not to expect the drug to immediately act as a magic bullet.

“We can instead hope for improved recovery rates and a reduction in patient mortality, which we hope will benefit as many patients as possible."