Remdesivir treatment duration

For patients with severe COVID-19 not requiring mechanical ventilation, 5 days of remdesivir may be as beneficial as 10 days, according to an open-label, industry-supported study in the New England Journal of Medicine. Nearly 400 patients with severe COVID-19 pneumonia were randomized to intravenous remdesivir for 5 or 10 days. At 14 days, 65% of patients in the 5-day group and 54% in the 10-day group had a clinical improvement of at least 2 points on a 7-point scale. After adjustment for baseline differences in disease severity, there was no significant difference in clinical improvement between the groups. The authors caution that “with no placebo control … the magnitude of benefit cannot be determined.” Editorialists advise: “In our current era of limited remdesivir supplies, priority should be given to a 5-day remdesivir regimen for patients at the early stages of severe disease.”

https://www.nejm.org/doi/full/10.1056/NEJMoa2015301?query=pfw&jwd=000000762462&jspc=CD

https://www.nejm.org/doi/full/10.1056/NEJMe2018715?query=pfw&jwd=000000762462&jspc=CD