Remdesivir is a nucleoside analog, one of the oldest classes of antiviral drugs. It works by blocking the RNA polymerase that coronaviruses and related RNA viruses need to replicate their genomes and proliferate in the host body.Remdesivir, in the spotlight as scientists and governments scramble to find a treatment for the disease, took a circuitous route to center stage. Born as a general antiviral candidate, researchers threw it at an array of viruses and saw where it stuck. It bounced along from Gilead’s labs to academic centers, nudged by both federal taxpayer dollars and support from the company. It kept turning up whiffs of potential in cells and animals infected by other coronaviruses like SARS and MERS, but these bugs weren’t causing sustained global crises. For years, Gilead was primarily focused on ushering remdesivir into trials and toward approval for a different kind of infection: Ebola.
The first COVID-19 patient diagnosed in the United States—a young man in Snohomish County, Washington—was given remdesivir when his condition worsened; he improved the next day, according to a case report in the New England Journal of Medicine (NEJM). A Californian patient who received remdesivir—and who doctors thought might not survive—recovered as well.
Remdesivir could be promising drug candidate to treat coronavirus
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Laboratory studies found remdesivir might work against SARS, a close cousin to the virus that has caused the current COVID-19 pandemic. Because of its promise, governments around the world acted quickly to set up formal studies to answer the question: Does remdesivir help patients with COVID-19 get better faster?
In early February, the Chinese government launched a randomized-controlled trial — considered the gold standard for research. Later that month, another randomized controlled trial sponsored by the United States National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, began at the University of Nebraska Medical Center in Omaha.
Dr. James Town, director of the medical intensive care unit at Harborview Medical Center in Seattl said: “There are trials going on for some of these things in some areas. All are rapidly enrolling, but their data won’t be back in time for a lot of places to make these decisions.”
The University of Minnesota is conducting three studies, including one on remdesivir for seriously ill patients. A second study will give hydroxychloroquine to people who have been exposed to the coronavirus, because they live in the same household as patients, to see if the drug can prevent them from becoming infected.
The third study will use an old, safe drug called losartan, normally given to treat high blood pressure, to find out whether it can prevent mild coronavirus infections from turning more serious. The drug blocks the receptor that the virus uses to get into cells, so researchers think it might stop or slow the illness.
“We’re trying to ask the question in the midst of the confusion and everything that’s going on, ‘Do these drugs help? Yes or no?’” Dr. Schacker said. “If no, let’s move on.”