Final practice points are issued for remdesivir use in COVID-19

In a living systematic review and updated article published online March 1 in the Annals of Internal Medicine, final practice points are presented for use of remdesivir for hospitalized patients with COVID-19.

Anjum S. Kaka, M.D., from the University of Minnesota School of Medicine in Minneapolis, and colleagues updated the living review of remdesivir for adults hospitalized with COVID-19. The authors note that one new randomized controlled trial (RCT) and one new subtrial comparing a 10-day course of remdesivir with a control (placebo or standard care) have been identified since the last update. Based on the evidence from five RCTs, the researchers found that the updated results confirm a 10-day course of remdesivir probably results in little to no reduction in mortality compared with control.

Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues updated the living, rapid practice points for the use of remdesivir as a COVID-19 treatment. The authors note that five days of remdesivir should be considered for hospitalized patients with COVID-19 who do not require invasive ventilation or extracorporeal membrane oxygenation (ECMO). Extending remdesivir to 10 days should be considered for patients who develop the need for invasive ventilation or ECMO within a five-day course. Initiation of remdesivir should be avoided for hospitalized patients with COVID-19 who are already on invasive ventilation or ECMO.

"The Scientific Medical Policy Committee has decided to retire this topic from living status in order to balance current priorities with existing resources, considering that surveillance was originally planned through December 2021 and the last three updates did not result in important changes to conclusions," Qaseem and colleagues write.

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