Organization recommends 5-day treatment course over standard 10-day course for moderate disease

PHILADELPHIA — The American College of Physicians released new Rapid Living Practice Points backing the use of the antiviral remdesivir for patients infected with Covid-19.

In its Practice Points, the ACP noted that evidence indicates “a net benefit for remdesivir in patients with moderate Covid-19 and suggests that a shorter treatment period (5 days) is as effective as a longer one (10 days), with no increase in harms.”

Based on this evidence, the ACP issued the following recommendations:

  • “Use remdesivir for 5 days as a treatment for patients with moderate Covid-19.
  • “Use remdesivir for 5 days as a treatment for patients with severe Covid-19 who do not require mechanical ventilation or extracorporeal membrane oxygenation (ECMO).
  • “Consider extending the use of remdesivir to 10 days in patients with severe Covid-19 requiring mechanical ventilation or ECMO within a 5-day course.”

“ACP’s Living Practice Points show that evidence comparing 5-day vs. 10-day course indicated that a 5-day course of remdesivir may slightly reduce mortality and may slightly increase clinical improvement compared with a 10-day course,” the ACP explained. “Evidence for potential harms showed that a 5-day course may result in slightly fewer adverse events (any) compared with a 10-day course, although the shorter course may not result in fewer serious adverse events.”

The physicians’ organization pointed out that there is no evidence that either course of remdesivir has any effect on other critical outcomes such as recovery or hospital length of stay, or on important outcomes, including time to recovery, time to clinical improvement, invasive mechanical ventilation/ECMO, and non-serious adverse events.

“With remdesivir there is evidence of benefit with shorter duration treatment for patients with both moderate or severe COVID-19,” said Jacqueline W. Fincher, MD, ACP President, in a statement, “which is positive news in the search for treatments of patients with Covid-19. However, significant evidence gaps remain and additional rigorous studies are needed to assess the benefits and harms of using remdesivir to treat patients with Covid-19.”

The ACP’s Practice Points suggested that future studies assessing use of remdesivir for Covid-19 should focus on treatment duration by symptom severity and assess clinical outcomes such as respiratory failure.

John McKenna, Associate Editor, BreakingMED™

Cat ID: 190

Topic ID: 79,190,730,933,190,926,192,927,151,928,925,934