Remdesivir for the treatment of COVID 19: review of the pharmacological properties, safety and clinical effectiveness

ABSTRACT

Introduction

Remdesivir is a nucleoside analog that inhibits viral RNA replication by blocking RNA-dependent RNA polymerase. First developed and tested during the Ebola epidemic, repurposed, and gained prominence during the Coronavirus disease 19 (COVID-19) pandemic. Based on data from three major trials, remdesivir became the first and only medication to obtain approval from the Food and Drug Administration (FDA) to treat patients hospitalized with COVID-19 disease.

Areas covered

The purpose of the article is to review available preclinical, clinical, and post-marketing data to assess the safety and efficacy of remdesivir in the treatment of COVID-19 patients. We performed a comprehensive literature review of articles published on remdesivir until January 2021.

Expert opinion

The substantial evidence of its effectiveness in a few trials together with the favorable safety profile makes remdesivir a primary therapeutic candidate for treatment in adult and pediatric patients who are hospitalized with COVID-19 and requiring oxygen supplementation. While remdesivir does not improve mortality, it has been shown to reduce the recovery time and increase the odds for clinical improvement, specifically in patients with early presentation and moderate COVID-19 disease. Remdesivir is well tolerated and has an acceptable safety profile in the pediatric and adult populations.

KEYWORDS:

• Acute respiratory distress syndrome
• antiviral medication
• coronavirus disease
• COVID-19
• GS-5734
• pandemic
• remdesivir
• drug safety

Drug box summary

Table

Chemical structure obtained from PubChem under creative commons license [57]

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript received consultancy fees from Mylan and educational support and research grant from Gilead Sciences. All other peer reviewers on this manuscript have no relevant financial or other relationships to disclose.