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The first Covid-19 drug to show promise in trials, reducing the time it takes for sick people to recover in hospital, is unlikely to be available in the UK anytime soon.
Forty-six people in the UK have received remdesivir as part of the European arm of an international trial. The researchers wish they had administered the drug to more patients, but did not have the supplies.
Professor Mahesh Parmar, director of the MRC clinical trials unit at University College London, who led the arm of the trial in the UK, said that participating allowed the unit to obtain a drug that was previously believed to have potential for some patients.
“It is very difficult to obtain the medicine. The trial gave us access to remdesivir, ”he said in a briefing. “I think supply is going to be a real problem.”
The drug, made by the American pharmaceutical company Gilead Sciences, shortened the duration of the disease from 15 days to 11 in a trial involving more than 1,000 patients in 75 hospitals around the world. Early results suggested that more patients survived, with 8% of those who died from the drug, compared to 11.6% of those who received a placebo.
“It is very exciting, but we must be careful not to exaggerate what we know to date,” Parmar said. Full test data has not yet been released and the licensing process must begin.
Although the researchers said they did not see the side effects, the drug can cause liver and kidney-related problems, they said.
Brian Angus, professor of infectious diseases at the Nuffield Department of Clinical Medicine in Oxford, who enrolled patients at the city’s Churchill Hospital, said: “It is not a panacea. We have to learn how to give it, when to give it and who will benefit the most. ”
Remdesivir is one of the few drugs identified by the World Health Organization (WHO) for its potential. Donald Trump has also said it is promising. There has been an avalanche of supplies of the drug, which was first tested for Ebola, but was rejected in the Democratic Republic of the Congo when monoclonal antibody drugs worked better.
It was intended to be tested against Covid-19 in the recovery trial, which runs in Oxford, which compares five different drugs in more than 8,000 patients, but scientists were unable to secure supplies.
The researchers involved in the new trial, called ACTT (Covid-19 Adaptive Treatment Trial) say remdesivir is likely to be used in combination with other drugs that are also promising.
Andrew Hill, principal investigator at the University of Liverpool Institute for Translational Medicine, warned that a remdesivir trial in China it had shown no benefit, although it was stopped early when the number of patients in the hospital fell too low to recruit enough.
There were other uncertainties. A smaller trial by Gilead of fewer than 400 patients showed that five days of treatment seemed to produce better results than 10 days. Almost two-thirds (65%) of patients who took the drug for five days recovered, and 54% of those who took it for 10 days. There was a similarity in mortality rates, which were 8% and 11% respectively.
Gilead said the drug was already accessible in the UK through clinical trials, its expanded access program and compassionate use requests.
“If remdesivir is shown to be a safe and effective drug for the treatment of Covid-19, we are committed to making remdesivir accessible and affordable to governments and patients around the world,” he said.
“Gilead has proactively expanded the manufacturing of remdesivir to increase the available supply as quickly as possible in anticipation of possible future needs. We have increased supply nearly thirty times since January, and our goal is to produce 1 million or more treatments by the end of the year and several million by 2021 if needed. “
He said he was working with regulatory authorities around the world, including those in the UK, “to determine the best way to help with this public health emergency.”
