We’ve all seen the news about how the Food and Drug Administration (FDA) just gave rare emergency authorization use approval to a medication called remdesivir (Rem des eh veer) – making it the first approved treatment for COVID-19 – but only temporarily and for very ill patients.
There was an interesting article in Friday’s New York Times, here, about remdesivir’s unlikely journey from failed hepatitis or ebolavirus treatment to approved Coronavirus treatment – which involves a scientist from Vanderbilt University and a lot of Federal funding – but here we’ll just focus on some of the science.
How does it work?
Remdesivir (shown above) was developed by Gilead and is a broad-spectrum antiviral medication (meaning it works to varying degrees against a wide range of viruses). Remdesivir is a prodrug, which means that it needs to be converted by enzymes in our bodies to its active form and is given by injection into the vein. In its active form, it looks like adenosine triphosphate, one of the building blocks of RNA (ribonucleic acid), which is the type of genetic material found in coronaviruses. While remdesivir looks enough like this building block to be taken up into the virus’s replication (copying) machinery, it causes a termination of the RNA chain and thus stops the virus from multiplying.
The most common side effects reported in the clinical trials studies of remdesivir for COVID-19 include respiratory failure and biomarkers (indicators) in the blood for organ impairment, including low potassium, low red blood cell count, low counts of platelets that help with blood clotting, and yellow discoloration of the skin. Other reported side effects include gastrointestinal distress, increased liver enzymes and reactions at the site of infusion.
While the clinical trials were fairly limited, “The data shows that remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery,” said Anthony Fauci, M.D., head of the National Institutes of Allergy and Infectious Diseases in a press conference on April 29, 2020. Earlier trials for ebolavirus have established it safety and the FDA has given emergency use authorization for treatment of patients hospitalized with severe COVID-19. Most agree this is a positive first step in building an arsenal for treatments for this disease.
Stay safe and curious, Friends!