WHO Recommends Against Remdesivir for COVID-19

The World Health Organization (WHO) released a conditional recommendation on November 20 against the use of remdesivir in patients hospitalized with COVID-19, regardless of severity of illness. WHO cites a lack of evidence surrounding remdesivir use and survival improvement as the reason behind this recommendation.

WHO’s coronavirus guidelines are created by an international guideline development group, composed of 28 clinical care experts, 4 patient partners, and one ethicist, in collaboration the nonprofit Magic Evidence Ecosystemic Foundations (MAGIC).

The panel reviewed data from 4 randomized controlled trials, with a total of more than 7000 patients. Evidence collected from the trials did not demonstrate improved outcomes for patients, such as reduced mortality, need for ventilation, and time to clinical improvement.  The Solidarity Trial, led by WHO, demonstrated little to no effect on 28-day mortality or length of hospital stay for patients with COVID-19.

The denotation of the recommendation as “conditional” indicates that more research is needed. Based on the current data, there is not enough evidence to support the use of remdesivir; more data surrounding the benefits and risks of remdesivir are needed.

These recommendations are not binding, the COVID-19 WHO guidelines are considered “living guidelines,” meaning they will be continually updated as more information becomes available. They serve as guidance to health care providers who need to make clinical decisions about patients in fast-moving situations, like the COVID-19 pandemic.

The US Food and Drug Administration has currently granted emergency use authorization to 2 medications for the treatment of COVID-19: remdesivir and baricitinib (to be used in combination with remdesivir).

—Audrey Amos, PharmD

Reference:

WHO recommends against the use of remdesivir in COVID-19 patients. News Release. World Health Organization. Published November 20, 2020. Accessed November 23, 2020. https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients