Dr. Srinivas Murthy, lead investigator on the Canadian Treatments for COVID-19 trial
The Canadian arm of the world’s largest randomized control trial on COVID-19 therapeutics has shown that the antiviral medicine remdesivir reduces the need for mechanical ventilation in hospitalized COVID-19 patients.
The results were published today in CMAJ (Canadian Medical Association Journal).
The study, called the Canadian Treatments for COVID-19 (CATCO) trial, is part of the World Health Organization’s global Solidarity trial which is examining the effects of various treatments for COVID-19. The Canadian wing of the trial is led by Dr. Srinivas Murthy, a clinical associate professor in UBC’s department of pediatrics and investigator at BC Children’s Hospital.
With the participation of 52 Canadian hospitals, the Canadian researcher team studied the effect of remdesivir in hospitalized patients with COVID-19 between August 2020 and April 2021. A total of 1,267 patients were included, with about half randomized to receive remdesivir treatment and the others assigned to a control group receiving standard of care.
The trial found that the need for mechanical ventilation was 8 per cent in patients receiving remdesivir compared to 15 per cent in the control arm. Patients treated with remdesivir were also able to come off oxygen and mechanical ventilators sooner. At day 28 of the study, the average oxygen-free and ventilator-free days were 15.9 and 21.4 in the remdesivir group compared with 14.2 and 19.5 in the control group.
“This may have important implications for patients and for health systems, particularly when ICU capacity, mechanical ventilation or oxygen are in limited supply.”
Dr. Srinivas Murthy
“The benefit of treatment was most apparent for preventing the need for mechanical ventilation, suggesting probable added value for patients with less severe disease to avoid progression during hospital stay,” writes Dr. Murthy. “This may have important implications for patients and for health systems, particularly when ICU capacity, mechanical ventilation or oxygen are in limited supply.”
Evidence has been mixed on the effect of remdesivir, a repurposed antiviral medication originally used to help treat Ebola. Health Canada authorized the use of remdesivir to treat COVID-19 patients in July 2020. However, in November 2020, the World Health Organization updated its ongoing guidance on COVID-19 medications to advise against the use of remdesivir.
The results of the CATCO trial add to the growing body of knowledge on remdesivir, suggesting it could help improve outcomes important to patients and health systems.
The Canadian trial was able to collect more detailed data compared with some other countries, as well as engaging patients across a range of ethnicities, particularly important for applications in other countries and in multicultural societies. It also represented the largest single country trial of remdesivir reported to date.
“The findings of CATCO are also important and complementary to Solidarity as they help to address questions of generalizability of a large simple protocol carried out across a wide range of hospitals and health care systems from low-, middle- and high-income countries,” the authors of the study conclude.
This story is based on a news release from CMAJ.