Infectious Disease

ACP updates tips on remdesivir as a COVID-19 therapy

February 10, 2021

1 min read

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Qaseem does not report any relevant financial information. In the document you will find all relevant financial information from all other authors.

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ACP states that they are reaffirming their previous Rapid Living Practice Points that 5 and 10 day remdesivir courses in hospitalized non-pregnant adults with COVID-19 provide a “net benefit” over placebo or standard care.

In contrast to the first version, the latest exercise points use requirements for airway support (e.g. no requirement, additional oxygen, mechanical ventilation / extracorporeal membrane oxygenation) instead of characterizing the disease as “moderate” or “severe” to indicate the severity of COVID-19 notify the organization.

Reference: Qaseem A, et al. Ann Intern Med. 2021; doi: 10.7326 / M20-8101.

The update is based on a new study and a study that was completed in the interval between the first and second version of the exercise points. Amir Qaseem, MD, PhD, MA, and other members of the ACP’s Scientific Medical Policy Committee (SMPC) wrote in the Annals of Internal Medicine.

The updated recommendations are:

  • Consider 5 days of remdesivir for hospitalized patients with COVID-19 who do not require mechanical ventilation or extracorporeal membrane oxygenation;
  • Consider extending Remdesivir treatment to 10 days for hospitalized patients with COVID-19 who require mechanical ventilation or extracorporeal membrane oxygenation within a 5-day course. and
  • Avoid starting remdesivir treatment for hospitalized patients with COVID-19 who are already on mechanical ventilation or extracorporeal membrane oxygenation.

“An important area of ​​uncertainty concerns the use of remdesivir in patients who do not require supplemental oxygen in the hospital, although we expect most patients diagnosed with COVID-19 will be admitted with signs and symptoms of the respiratory tract,” wrote Qaseem and the committee . “Given the limited treatment options for COVID-19, the SMPC found the evidence insufficient to advise against the use of remdesivir in patients who do not require supplemental oxygen at the time of drug initiation.”

Amir Qaseem

The updated exercise points are based on a systematic review by the Minneapolis VA Evidence Synthesis Program that was updated through December 7, 2020, wrote Qaseem and colleagues. Further updates are currently planned for every 2 months until December.

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