大规模的WHO remdesivir研究表明Covid-19无益处

大规模的WHO remdesivir研究表明Covid-19无益处

医生不是很确定。

这并不意味着remdesivir — 5月份获得美国食品药品监督管理局(FDA)的紧急使用授权

-但是对Covid-19无效。 全面报道冠状病毒爆发新研究

—包括来自30个国家/地区的11,200多人的数据

—是世界卫生组织的团结试验的结果。

Remdesivir:

It was published online Thursday on the preprint server medRxiv, meaning it has not been peer-reviewed.

Remdesivir wasn’t the only treatment given to patients in the trial.

The trial found that overall,

remdesivir did not reduce deaths and did not help patients with severe Covid-19 get out of the hospital more quickly.

hydroxychloroquine

lopinavir

interferon

Some received hydroxychloroquine (which has since been shown to be ineffective in treating Covid-19), lopinavir (an antiviral used in HIV treatment) and interferon (another antiviral).

Some received a combination of the drugs. Others got just one. Still others received no treatment.

https://www.nbcnews.com/health/health-news/massive-who-remdesivir-study-suggests-no-covid-19-benefit-doctors-n1243730

Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results edRxiv

Abstract

BACKGROUND WHO expert groups recommended mortality trials in hospitalized COVID-19 of four re-purposed antiviral drugs.

METHODS

Study drugs were

Remdesivir,
Hydroxychloroquine,
Lopinavir (fixed-dose combination with Ritonavir)
Interferon-β1a (mainly subcutaneous; initially with Lopinavir, later not).

COVID-19 inpatients

were randomized equally between whichever study drugs were locally available and open control (up to 5 options: 4 active and local standard-of-care).

The intent-to-treat primary analyses

are of in-hospital mortality in the 4 pairwise comparisons of each study drug vs its controls (concurrently allocated the same management without that drug, despite availability).

Kaplan-Meier 28-day risks are unstratified; log-rank death rate ratios (RRs) are stratified for age and ventilation at entry.

RESULTS In 405 hospitals in 30 countries

11,266 adults were randomized, with 2750 allocated Remdesivir,

954 Hydroxychloroquine,

1411 Lopinavir,

651 Interferon plus Lopinavir,

1412 only Interferon,

4088 no study drug.

Compliance was 94-96% midway through treatment, with 2-6% crossover.

1253 deaths were reported (at median day 8, IQR 4-14).

Kaplan-Meier 28-day mortality was 12% (39% if already ventilated at randomization, 10% otherwise).

Death rate ratios (with 95% CIs and numbers dead/randomized, each drug vs its control) were: Remdesivir RR=0.95 (0.81-1.11, p=0.50; 301/2743 active vs 303/2708 control),

https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1