US-based health system Providence has reported that Gilead Sciences’ anti-viral drug, remdesivir, reduced mortality by 40% compared with best supportive care in hospitalised Covid-19 patients who were receiving low flow oxygen.

The study had 286 subjects on remdesivir and 852 participants on best supportive care, with all of them enrolled between 28 February and 28 May last year.

Nearly 400 subjects were given hydroxychloroquine as best supportive care in the study.

Providence noted that the study was carried out when remdesivir was not used as the standard-of-care and before the drug received emergency use authorization (EUA) from the US Food and Drug Administration.

The FDA authorisation was based on enhanced time to recovery but the drug’s effect on mortality improvement is yet to be determined.

In the latest study, apart from mortality reduction, the remdesivir treatment indicated effectiveness during the virological phase and prior to substantial development of hyperinflammation, as defined for the dynamic and bimodal Covid-19 disease process.

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Providence antimicrobial stewardship and infection prevention medical director George Diaz said: “These findings are significant because they highlight the urgent need to define optimal treatment of Covid-19.

“It shows that remdesivir was associated with lower mortality compared to best supportive care for certain patients.

“I hope this new data encourages physicians to use remdesivir according to IDSA treatment guidelines which recommends its use.”

In a study supported by the World Health Organization (WHO), mortality benefit linked to the use of remdesivir against placebo was not observed.

Providence noted that the WHO-supported study did not describe the level of oxygen support in ‘granular detail’, thereby potentially masking a mortality benefit when taken in the early stage of the disease.

The National Institute of Health-funded ACTT-1 trial found potential mortality benefit of the drug use in Covid-19 patients needing low flow oxygen.

In June 2021, Gilead reported that real-world data from three retrospective studies showed its antiviral treatment, Veklury (remdesivir), reduced the risk of mortality in hospitalised Covid-19 patients.