More on Covid-19

NEW DELHI: India is part of the WHO ‘solidarity trials’ for the drug Remdesivir, which has shown encouraging results in serious Covid-19 patients needing enhanced oxygen and ventilator support, and will be able to access any benefits that accrue from the anti-viral medication once it is established for clinical use. Tests were carried out with Remdesivir, developed for use against Ebola.The tests showed significant benefits for two-thirds patients with severe symptoms during use on a set of patients in the US, Canada, Europe and Japan, said Dr Raman Gangakhedkar of Indian Council of Medical Research at the health ministry briefing on Monday. The tests, he clarified, were not clinical trials.The drug was able to help about two-thirds of the patients to get off oxygen and ventilator support, he said.According to a report published in the New England Journal of Medicine (NEJM), 53 people in the US (22), Europe or Canada (22) and Japan (9), who were on respiratory support received Remdesivir for up to 10 days on a compassionate use basis. These patients were administered 200 mg of Remdesivir intravenously on day one, followed by 100 mg daily for the remaining nine days of treatment.The NEJM report said that at baseline, before administration of drug, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation — a life support system used when lungs cannot provide enough to the body even when given extra oxygen.Eighteen days later, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were able to get off the breathing device. A total of 25 patients (47%) were discharged, and seven patients (13%) died, according to the NEJM article published on April 10.Dr Gangakhedkar, who heads the division of epidemiology and communicable diseases at ICMR, said India was part of the ‘solidarity trial’ being led by the WHO which is analysing the efficacy of Remdesivir and other drugs for Covid-19 management.“Remdesivir was being used in the Ebola outbreak. The drug acts on the mutation of the Covid-19 virus, which is why researchers believe that it could work," he said. The chief epidemiologist of ICMR, however, clarified that the article published in NEJM involved an observational trial and not a clinic study.According to a draft report of WHO’s R&D Blueprint, which was released last month, Remdesivir is the ‘most promising candidate’ among the different therapeutic options for treating persons affected by Covid-19. This is because in-vitro (tests performed in test tube) and in-vivo (tests performed in living organism) data for the drug is available for coronaviruses.“Further, studies in mice using Remdesivir showed superior efficacy over the drugs Kaletra+IFNbeta,” the draft report said. Remdesivir slows the infection of healthy cells by blocking viral replication.WHO experts also reviewed drugs used in HIV treatment — lopinavir and ritonavir — either alone or in combination with IFNbeta. It said among the repurposed drugs under consideration, this would be the suitable second option for rapid implementation in clinical trials.