The following is a summary of “Efficacy and safety of remdesivir alone and in combination with other drugs for the treatment of COVID-19: a systematic review and meta-analysis,” published in the October 2023 issue of Infectious Disease by Chen et al.
Remdesivir is a promising antiviral drug for the treatment of COVID-19. Researchers started a retrospective study to evaluate the clinical efficacy and safety of remdesivir alone and in combination with other drugs for COVID-19.
They searched the PubMed, Embase, SCIE, Cochrane Library, and American Clinical Trial Center databases up to 1 April 2022 to identify randomized controlled trials (RCTs) and observational studies that contrasted the efficacy of remdesivir monotherapy and combination therapy with control drugs.
The results showed 10 RCTs and 32 observational studies. For the main outcome, remdesivir reduced mortality in severe COVID-19 patients (RR = 0.57, 95% CI (0.48, 0.68)) and hastened clinical improvement (MD = -2.51, 95% CI (-2.75, -2.28)). Regarding other clinical outcomes, remdesivir was linked to improved clinical status (RR = 1.08, 95%CI (1.01, 1.17)). In terms of safety outcomes, remdesivir didn’t lead to liver or kidney damage (RR = 0.87, 95% CI (0.68, 1.11)) (RR = 0.88, 95% CI (0.70,1.10)). When combined with other drugs (e.g., steroids, favipiravir, and convalescent plasma), remdesivir had no impact on mortality compared to remdesivir alone.
Investigators concluded that Remdesivir reduces mortality and shortens time to recovery in severe COVID-19, but combination therapy shows no added benefit.