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Remdesivir:five Australian hospitals to receive experimental coronavirus drug

Exclusive: St Vincent’s in Sydney is the onlyconfirmed location so far, as NSW Health negotiates with US pharmaceuticalgiant Gilead

· Remdesivir: theantiviral drug is being touted as a possible coronavirus treatment – but willit work?

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The US pharmaceutical company Gilead is finalising the locationof five hospitals in Australia to receive the highly sought-after experimentalcoronavirus drug remdesivir.

The onlyconfirmed location is St Vincent’s hospital in Sydney, a major tertiary hospital and the centre of many of the New South Wales outbreak areas. A NSW Health spokeswoman confirmed the health department “has been engaging with Gilead on gaining access to the drug for Covid-19 patients”.

The newscomes as the doctor informing the Covid-19 response in the White House, theimmunologist Dr Anthony Fauci, promotedpreliminary findings from a joint Gilead and National Institute of Allergy and Infectious Diseases study that suggested remdesivir could improve recovery time of patients. His comments have revived global hope in the drug, with no treatments now available for the virus.

Remdesivir:the antiviral drug is being touted as a possible coronavirus treatment – butwill it work?

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But experts have warned that the study findings areunpublished and preliminary. The US clinical trial registry also shows thatGilead altered the primary outcome measures of the trial halfway through. Itbroadened its definition of “recovery” and included patients who were still inhospital and who were at home but requiring oxygen in its group of recoveredpatients. Changing the primary outcomes of a study is often viewed byscientists with scepticism in any clinical trial, as it is often done toimprove the significance of results after the initial outcomes proveddisappointing. This is known as “fishing for significance”. Nine members of theUS panel that establishes treatment guidelines have a financial interest in Gilead.

A separate study from China published in theprestigious medical journal the Lancet showed no statistically clinical benefitin Covid-19 patients in health improvement or mortality after they were givenremdesivir. But the researchers tested a smaller number of patients than the UStrial and concluded that their findings would require confirmation from largerstudies. The study was stopped early by the data safety monitoring boardbecause of difficulty recruiting patients.

Even if the drug does ultimately prove effective, it is likelyto be used in a similar way to the influenza drug Tamiflu, shortening theduration of illness but not curing it. The US study showed patients givenremdesivir improved only moderately, after an average of 11 days, compared withan average of 15 days for those not given the treatment.

DrGaetan Burgio, head of the transgenesis facility at the John Curtin School ofMedical Research at the Australian National University in Canberra, said thestudies so far revealed remdesivir “is not a silver bullet against Covid-19”.

“It is therefore more critical than ever to keep socialdistancing, wearing masks or follow other preventive measures to limit thespread and eliminate the virus,” Burgio said.

ProfSarah Palmer, the co-director of the Centre for Virus Research at the WestmeadInstitute for Medical Research in Sydney, said: “There is still a lot to learnabout this disease.

“Wecannot base our medical response on this one promising study. This drug isstill in early clinical trials and is not currently widely available. It ispossible depending upon a wide range of issues including, production,licensing, urgency that it will become available in Australia in the future.”