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Clin Drug Investig . Effectiveness and Safety of Remdesivir in Treating Hospitalised Patients with COVID-19: A Propensity Score Analysis of Real-Li

tetano

Editor, Senior Moderator
Clin Drug Investig


. 2023 Sep 22.
doi: 10.1007/s40261-023-01304-4. Online ahead of print. Effectiveness and Safety of Remdesivir in Treating Hospitalised Patients with COVID-19: A Propensity Score Analysis of Real-Life Data from a Monocentric Observational Study in Times of Health Emergency

Nicola Ughi[SUP] 1 [/SUP], Davide Paolo Bernasconi[SUP] 2 [/SUP], Francesca Del Gaudio[SUP] 3 [/SUP], Armanda Dicuonzo[SUP] 3 [/SUP], Alessandro Maloberti[SUP] 4 5 [/SUP], Cristina Giannattasio[SUP] 4 5 [/SUP], Paolo Tarsia[SUP] 6 [/SUP], Giovanna Travi[SUP] 7 [/SUP], Francesco Scaglione[SUP] 8 9 [/SUP], Fabrizio Colombo[SUP] 10 [/SUP], Michaela Bertuzzi[SUP] 11 [/SUP], Antonella Adinolfi[SUP] 12 [/SUP], Maria Grazia Valsecchi[SUP] 2 [/SUP], Claudio Rossetti[SUP] 3 13 [/SUP], Oscar Massimiliano Epis[SUP] 12 [/SUP]; Niguarda COVID Working Group



Affiliations
Abstract

Background and objectives: Remdesivir is an antiviral agent, which was shown to be safe and effective in treating early COVID-19, but its favourable impact in hospitalised patients with non-critical disease is still under investigation. The present study aimed to assess the effectiveness and safety of remdesivir as a treatment for hospitalised patients with COVID-19 by a propensity score analysis of observational data.
Methods: In this monocentric retrospective cohort study, the effectiveness and safety of a 5-day course of remdesivir (200 mg intravenously at Day 1, then 100 mg from Days 2-5) in association with the standard of care were assessed in comparison with the standard of care only. The primary endpoint was the proportion of recovery on Day 14.
Results: Of 3662 eligible inpatients who tested positive for the severe acute respiratory syndrome coronavirus 2 genome by nasopharyngeal swab at admission, 861 (24%) non-critical patients were included in a propensity score analysis and 281 (33%) were exposed to remdesivir. In total, 242/281 (86.1%) and 435/580 (75.0%) patients recovered in exposed and non-exposed, respectively, with a relative improvement of 11.1% (95% CI + 5.8 to 16.5%; unadjusted odds ratio: 2.07, 95% CI 1.40-3.05, p = 0.0001; after adjustment by propensity score weighting, odds ratio: 1.92, 95% CI 1.30-2.83, p = 0.001). In treated patients, 1 (0.03%) anaphylactic reaction and 1 (0.03%) acute reaction during drug injection were reported, and 24 (8.5%) patients stopped the treatment due to adverse reactions. No significant differences were found with respect to the secondary efficacy endpoints (in-hospital all-cause death, need for intensive care treatments, clinical improvement score at Day 28) and safety endpoints (any and serious adverse reactions).
Conclusion: A 5-day course of remdesivir in association with the standard of care effectively promoted recovery from COVID-19 among non-critical in-hospital patients and had an acceptable safety profile.


 
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