Remdesivir

(Veklury®)

Remdesivir

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Drug updated on 5/17/2024

Dosage FormInjection (intravenous; 100 mg lyophilized powder, 100 mg/20 mL [5 mg/mL] in a single dose vial)
Drug ClassSARS-CoV-2 nucleotide analog RNA polymerase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of coronavirus disease 2019 (COVID-19) in adults and pediatric patients (birth to less than 18 years of age weighing at least 1.5 kg) who are hospitalized, or not hospitalized and have mild-to-moderate COVID-19, and are at high risk for progression to severe COVID-19, including hospitalization or death.

Summary
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  • Remdesivir (Veklury) is indicated for the treatment of COVID-19 in adults and pediatric patients, regardless of hospitalization status, but especially for those at high risk of progressing to severe disease. It potentially reduces all-cause mortality and the duration of hospitalization, especially when started early in the disease course.
  • A total of 50 systematic reviews/meta-analyses, which included randomized controlled trials and observational studies on remdesivir's therapeutic effects against COVID-19, were evaluated.
  • Compared to standard care, remdesivir results in higher clinical improvement rates without a significant increase in serious adverse events. However, its impact on reducing the need for mechanical ventilation or ICU admission varies.
  • The effectiveness of remdesivir may depend on how early treatment is initiated, with early treatment being potentially more beneficial. There is limited data on its use in specific groups such as pediatric patients and pregnant women, indicating a need for more research.
  • When compared with other treatments like corticosteroids and IL6 inhibitors, which might offer survival benefits in severe cases of COVID-19, remdesivir is primarily considered an early intervention aimed at preventing disease progression rather than as a treatment in the late stages.
  • Other antiviral agents like hydroxychloroquine and lopinavir/ritonavir have not shown significant benefits in treating COVID-19, making remdesivir a more favorable option, especially compared to treatments with unclear outcomes or potential harms.
  • The evidence indicates interest in combination therapies including remdesivir with corticosteroids or immune modulating drugs, which could optimize outcomes, particularly for those with moderate-to-severe cases; however, this requires confirmation through additional research.
  • Future research should focus on conducting randomized controlled trials involving broader demographic groups, including children and pregnant women; evaluating long-term outcomes and post-recovery effects following remdesivir treatment; investigating optimal combination therapies for effective use; and assessing its cost-effectiveness in varying health system contexts.

Product Monograph / Prescribing Information

Document TitleYearSource
Veklury (remdesivir) Prescribing Information.2024Gilead Sciences, Inc., Foster City, CA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Remdesivir for the treatment of COVID-19. 2023Cochrane Database of Systematic Reviews
Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials.2023The Lancet
Acute kidney injury in COVID-19 patients receiving remdesivir: a systematic review and meta-analysis of randomized clinical trials.2023Clinics
Remdesivir for the treatment of COVID-19.2023The Cochrane Database of Systematic Reviews
A systematic review and meta-analysis of randomized controlled trials with trial sequence analysis of remdesivir for COVID-19 treatment.2023International Journal of Critical Illness and Injury Science
Remdesivir-induced bradycardia and mortality in sars-cov-2 infection, potential risk factors assessment: a systematic review and meta-analysis. 2023Journal of Clinical Medicine
The effects of remdesivir on mortality and the requirement for mechanical ventilation in patients with COVID-19: a systematic review stratified by disease severity.2023The Korean Journal of Internal Medicine
Comparative efficacy and safety of anti-infective drugs for patients with mild to severe COVID-19: a systematic review and network meta-analysis of randomized controlled trials. 2023Ethiopian Medical Journal
Remdesivir for pregnancy: a systematic review of antiviral therapy for COVID-19. 2022Heliyon
Potentially effective drugs for the treatment of COVID‑19 or MIS‑C in children: a systematic review. 2022European Journal of Pediatrics
Efficacy of antiviral therapies for COVID-19: a systematic review of randomized controlled trials. 2022BMC Infectious Diseases
Comparative efficacy and safety of pharmacological interventions for severe COVID-19 patients: an updated network meta-analysis of 48 randomized controlled trials.2022Medicine
Efficacy of pharmacological interventions in COVID-19: a network meta-analysis.2022British Journal of Clinical Pharmacology
The clinical efficacy and safety of anti-viral agents for non-hospitalized patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials. 2022Viruses
Remdesivir for the treatment of patients hospitalized with COVID‑19 receiving supplemental oxygen: a targeted literature review and meta‑analysis.2022Scientific Reports
Adverse effects of remdesivir, hydroxychloroquine and lopinavir/ritonavir when used for COVID-19: systematic review and meta-analysis of randomised trials.2022BMJ Open
Efficacy of COVID-19 treatments among geriatric patients: a systematic review.2022Therapeutic Advances in Infectious Disease
Remdesivir administration in COVID-19 patients with renal impairment: a systematic review. 2022American Journal of Therapeutics
Use of remdesivir in patients with COVID-19: a systematic review and meta-analysis.2022Jornal Brasileiro de Pneumologia
Major update 2: Remdesivir for adults with COVID-19: a living systematic review and meta-analysis for the American College of Physicians practice points.2022Annals of Internal Medicine
Efficacy and safety of remdesivir in hospitalised COVID-19 patients: a systematic review and meta-analysis.2022Infection
Remdesivir for the treatment of COVID-19: a systematic review and meta-analysis.2022Clinical Microbiology and Infection
Remdesivir: a potential game-changer or just a myth? A systematic review and meta-analysis.2021Life Sciences
Remdesivir for treatment of COVID-19; an updated systematic review and meta-analysis. 2021European Journal of Pharmacology
Efficacy and safety of remdesivir in COVID-19 caused by SARS-CoV-2: a systematic review and meta-analysis. 2021BMJ Open
Major update: remdesivir for adults with COVID-19: a living systematic review and meta-analysis for the American College of Physicians practice points. 2021Annals of Internal Medicine
Effectiveness of remdesivir, lopinavir/ritonavir, and favipiravir for COVID-19 treatment: a systematic review. 2021International Journal of General Medicine
Clinical efficacy and safety of remdesivir in patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials. 2021Journal of Antimicrobial Chemotherapy
Remdesivir for the treatment of coronavirus COVID-19: a meta-analysis of randomised controlled trials. 2021Journal of Global Antimicrobial Resistance
Remdesivir for coronavirus disease 2019 (COVID-19): a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials. 2021Infectious Diseases
Efficacy of COVID-19 treatments: a Bayesian network meta-analysis of randomized controlled trials. 2021Frontiers in Public Health
Current evidence for COVID-19 therapies: a systematic literature review.2021European Respiratory Review
Immunomodulatory therapies for SARS-CoV-2 infection: a systematic literature review to inform EULAR points to consider. 2021Annals of the Rheumatic Diseases
Interventions for treatment of COVID-19: second edition of a living systematic review with meta-analyses and trial sequential analyses (The LIVING Project).2021PLoS One
Comparative effectiveness of pharmacological interventions for Covid-19: a systematic review and network meta-analysis. 2021Frontiers in Pharmacology
Antiviral drugs for coronavirus disease 2019 (COVID-19): a systematic review with network meta-analysis. 2021Expert Review of Anti-infective Therapy
Remdesivir and its antiviral activity against COVID-19: a systematic review.2021Clinical Epidemiology and Global Health
Remdesivir therapy in patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials. 2021Annals of Medicine and Surgery
Remdesivir for adults with COVID-19: a living systematic review for American College of Physicians practice points.2021Annals of Internal Medicine
The safety, tolerability and mortality reduction efficacy of remdesivir; based on randomized clinical trials, observational and case studies reported safety outcomes: an updated systematic review and meta-analysis. 2021Therapeutic Advances in Drug Safety
Third force in the treatment of COVID-19: a systematic review and meta-analysis. 2021Annals of Medicine and Surgery
Protocol: Benefits and harms of remdesivir for COVID-19 in adults: a systematic review with meta-analysis.2021PloS One
Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: a systematic review and network meta-analysis.2020PLoS Medicine
Immune therapy, or antiviral therapy, or both for COVID-19: a systematic review. 2020Drugs
SARS-CoV-2 pharmacologic therapies and their safety/effectiveness according to level of evidence.2020American Journal of Emergency Medicine
Evaluation of current medical approaches for COVID-19: a systematic review and meta-analysis.2020BMJ Supportive & Palliative Care
Interventions for treatment of COVID-19: a living systematic review with meta-analyses and trial sequential analyses (The LIVING Project).2020PLOS Medicine
Drug treatments for covid-19: living systematic review and network meta-analysis.2020BMJ
Efficacy of various treatment modalities for nCOV-2019: a systematic review and meta-analysis.2020European Society for Clinical Investigation
Efficacy and harms of remdesivir for the treatment of COVID-19: a systematic review and meta-analysis.2020PLoS One
Systematic review on the therapeutic options for COVID-19: Clinical evidence of drug efficacy and implications.2020Infection and Drug Resistance

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