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Efficacy of early use of remdesivir: a systematic review of subgroup analysis.
Gil-Sierra, M D; Briceño-Casado, M P; Alegre-Del Rey, E J; Sánchez-Hidalgo, M.
  • Gil-Sierra MD; Manuel David Gil-Sierra, Pharmacy Department, Hospital Universitario Puerto Real. Carretera. N-IV Km. 665, 11510 Puerto Real, Cadiz, Spain. mangilsie@yahoo.com.
Rev Esp Quimioter ; 35(3): 249-259, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1744333
ABSTRACT

OBJECTIVE:

A possible benefit has been suggested for early treatment of severe coronavirus disease 2019 (COVID-19) with remdesivir. The efficacy of this drug is controversial and could significantly influence the efficiency in healthcare systems. The objective is the methodological interpretation of subgroup analyzes according to starting of remdesivir treatment with respect to symptom onset of COVID-19.

METHODS:

A search in Pubmed® database was performed. Randomized clinical trials (RCTs) with subgroup analysis regarding early and late use of remdesivir were selected. All endpoints were assessed using two methodologies. First methodology considered statistical interaction, pre-specification, biological plausibility, and consistency of results. Second methodology was a validated tool with preliminary questions to discard subset analysis without relevant minimum conditions, and a checklist with recommendations for applicability.

RESULTS:

A total of 54 results were found and five RCTs were selected. According first methodology, consistent heterogeneity was only found in time to clinical improvement and better clinical status score at day 15 for patients with severe COVID-19 and <7 days of symptoms. About second methodology, these results about early use of remdesivir may be applied to clinical practice with caution.

CONCLUSIONS:

We developed a systematic search and application of an established methodology for interpretation of subgroup analysis about early use of remdesivir. Results in severe COVID-19 suggested that early use of remdesivir provides a greater benefit in <7 days of symptoms for time to clinical improvement and better clinical status score at day 15. Future studies could use 7-day cut-off of symptoms to evaluate remdesivir.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Rev Esp Quimioter Journal subject: Drug Therapy Year: 2022 Document Type: Article Affiliation country: Req

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Drug Treatment Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Rev Esp Quimioter Journal subject: Drug Therapy Year: 2022 Document Type: Article Affiliation country: Req