Remdesivir drug to be available for selected NHS Covid-19 patientsNachelle Geronimo
Remdesivir drug to be available for selected NHS Covid-19 patients.
Drug pioneered for Ebola to be used in UK under emergency medicines provision
The UK health secretary called the planned NHS use of remdesivir “probably the biggest step forward in the treatment of coronavirus” since the pandemic began. Photograph: Reuters
A drug that reduces recovery time from Covid-19 will be made available to a number of NHS patients in “probably the biggest step forward in the treatment of coronavirus” since the pandemic began, the UK health secretary has said.
Matt Hancock on Tuesday welcomed the authorisation of the experimental antiviral drug remdesivir, which has been shown to reduce recovery time for patients in hospital with Covid-19 from 15 days to 11 days.
Made by the US company Gilead Sciences, and initially pioneered for the treatment of the Ebola virus, the drug was granted emergency authorisation for Covid-19 by the US and Japan early this month.
Now the UK has followed suit. The drug is to be made available to carefully selected NHS patients through the Early Access to Medicines Scheme, a programme that allows medicines to be used in emergency situations before they have been licensed, the drugs provided free by the company.
Remdesivir has been the subject of trials around the world in treating Covid-19, with mixed results. A trial in China that was terminated early on found little sign of benefit from the drug, although experts say that could be due to the small number of participants involved.
More promising was an international trial, which found it reduced the median recovery period of patients in hospital with Covid-19 from 15 days to 11 days.
Hancock told the Downing Street press briefing that the drug had given promising early results and that if the UK trials were successful health officials would be prioritising the use of the treatment where it would provide the greatest benefit.
He warned that only very early steps had been taken in the trial but added: “This is probably the biggest step forward in the treatment of coronavirus since the crisis began.”
Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said that the NHS had secured the drug on a provisional licence lasting a year, unless renewed, and that it meant the drug could be accessed legally while unlicensed.
He warned: “The amount of evidence on remdesivir’s efficacy and safety is still limited and it’s possible it will not become [fully] licensed. It is also not a recommendation for use. But it does allow clinicians to use the medicine outside one of the ongoing randomised trials without fear of it being regarded as bad practice.”
Lord Bethell, the minister for innovation, said the government would continue to monitor results from clinical trials involving remdesivir.
Not all NHS patients will be eligible for the drug. Evans said: “It is for the treatment of adults and adolescent patients hospitalised with suspected or laboratory-confirmed Covid-19 infection and severe disease, so it is not for use in general practice nor for prevention of disease in those who do not have Covid-19.”
The Department for Health and Social Care said: “Allocation of the drug will be based on expert clinical advice and will take into consideration the situation where it is most likely to provide the greatest benefit.”
Peter Horby, professor of emerging infectious diseases and global health at the University of Oxford, who is running the “Recovery” trial to find drugs to treat Covid-19 and was involved in the remdesivir trial in China, said the drug was a promising one.
“The [international] remdesivir trial [led by] the US is the first trial we have seen that has reported a positive result,” he said. “It clearly shows improvements in time to recovery.”
There were hints that the drug could also save lives as well, although more data was needed to confirm that, he said. “It is very welcome there is a positive result, there is a drug that may have a benefit and that is being made available on the NHS.”
The international study, Horby said, showed that the drug was most beneficial in patients who needed oxygen; it had less of an impact in those who were not so ill, and those in intensive care.
Dr Stephen Griffin, associate professor in the school of medicine at the University of Leeds, said it was likely that the most severe Covid-19 patients would receive remdesivir first.
He said: “While this is clearly the most ethically sound approach, it also means that we ought not to expect the drug to immediately act as a magic bullet. We can instead hope for improved recovery rates and a reduction in patient mortality, which we hope will benefit as many patients as possible.
“More pronounced benefit is likely to be seen when treating patients with less severe disease, ideally before they require invasive respiratory support, but this will only follow once the drug is more widely available and will be guided by the final outcomes of placebo-controlled trials.”
Prof Mahesh Parmar, director of the MRC clinical trials unit, at University College London, which ran the UK arm of the international trial, also welcomed the announcement. “It is great news that the UK regulator has approved the use of remdesivir for hospitalised patients with Covid-19 [under the scheme]. There is no doubt it is of real benefit to patients, speeding their time to recovery,” he said, although he raised concerns about supply problems.
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