The new corona virus made Dr. Jag Singh to a patient in his own hospital. His alarm went up when he saw an x-ray of his pneumonia and colleagues asked about his life support wishes while they were taking him to the Massachusetts General’s intensive care unit.
When they offered him the opportunity to test Remdesivir, an experimental drug that looks promising for some other coronaviruses, “it didn’t even occur to me to say ‘no’,” said Singh, a cardiac specialist.
Coronavirus patients around the world have rushed to participate in remdesivir studies that have started in hospitals in recent weeks.
The interest was so great that the U.S. National Institutes of Health is expanding its study, which has almost reached its original goal of 440 patients. California-based drugmaker Gilead Sciences is also quick to conduct its own studies.
“I would enroll my family immediately,” said Dr. Libby Hohmann, who brought Singh and nearly 30 others to the NIH at the General Fair. Not having approved drugs for Covid-19 is “kind of terrifying,” she said.
For most people, the new coronavirus causes mild or moderate symptoms, including fever and cough, but sometimes pneumonia, which requires hospitalization. The risk of death is higher for older adults and people with other health problems.
Remdesivir is given by IV. It is designed to disrupt an enzyme that reproduces viral genetic material.
In animal studies against SARS and MERS, diseases caused by similar coronaviruses, the drug helped prevent infections and reduced the severity of symptoms if given early enough in the course of the disease. Testing is more advanced than many other potential therapies, and recent studies may lead to regulatory approval.
Gilead has given remdesivir to more than 1,700 patients on a case-by-case basis, but ultimately more people will be helped if the company conducts the necessary studies to demonstrate safety and efficacy, managing director Dan O’Day wrote in a recent letter to the public.
“Many people have turned to Gilead to work on behalf of friends and loved ones to get access to Remdesivir. I can only imagine what it must feel like to be in this situation, ”he wrote. “We take an ethical, responsible approach.”
In another letter on Saturday, O’Day said the company had 1.5 million doses, which could mean more than 140,000 treatment courses, depending on how long the treatment would take. The company is currently making the drug available free of charge and has set itself the goal of completing 500,000 treatment courses by October and more than one million by the end of the year.
Gilead has delivered remdesivir for two studies in China that are expected to deliver results later this month. Two trials for hospitalized patients have also been started in the United States, Asia, Europe and elsewhere. One of the seriously ill patients tested five versus ten days of treatment. Another in moderately ill patients compares these two options with standard care alone.
“There is so much fear of the disease that the patients are very interested,” and nobody who was offered the opportunity refused, Dr. said. Arun Sanyal, the director of studies at Virginia Commonwealth University in Richmond.
The first patient he enrolled was a previously healthy middle-aged man who had a visitor outside the state a few days before his symptoms started. What started as a mild illness escalated into deep breathlessness that required additional oxygen.
At the Cleveland Medical Center at the university clinics, Dr. Grace McComsey enrolled approximately half a dozen patients.
“We are seeing more and more younger people, like 30, who are really sick,” she said.
The NIH study is the strictest test. It compares remdesivir to placebo infusions, and by the end of the study, neither patients nor doctors know who gets what. In addition to the United States, it is open in Japan, Korea and Singapore.
In Chicago, an 89-year-old man was the first attendee at Northwestern Memorial Hospital, and “the family was very excited” to take him in, said infectious disease chief Dr. Babafemi Taiwo.
At the University of California in Irvine, Dr. Alpesh Amin included several patients. Everyone is treated normally, even if they get a placebo rather than a remdesivir, Amin said.
Boston cardiologist Singh said he was ready to take this opportunity to advance science, even if he personally did not benefit from it. He is now recovering at home after spending a week in the hospital.
“The word ‘placebo’ scares some people,” but rigorous testing is required to avoid giving false hope or using something unsafe. Nevertheless, it is difficult to meet patients without proven therapy, Hohmann said.
“The worst thing is seeing some really young people who are really, really sick,” she said, such as a 49-year-old man with three young children who are life-sustaining. “It’s pretty awful.”