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BREAKING—wow—WHO just recommended **against** the use of @GileadSciences’s drug remdesivir in hospitalized #COVID19 patients, citing “there is currently no evidence that remdesivir improves survival or reduces need for ventilation in these patients”. 
https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients
https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients
2) “data from over 7000 patients across the 4 trials were considered.
The evidence suggested no important effect on mortality, need for mechanical ventilation, time to clinical improvement, and other patient-important outcomes.
The guideline development group...”
The evidence suggested no important effect on mortality, need for mechanical ventilation, time to clinical improvement, and other patient-important outcomes.
The guideline development group...”
3) “recognized that more research is needed, especially to provide higher certainty of evidence for specific groups of patients. They supported continued enrollment in trials evaluating remdesivir.”
4) WHO gave a “conditional recommendation”: issued when the evidence around the benefits and risks of an intervention are less certain. In this case, there is a conditional rec against the use of remdesivir. This means that there isn’t enough evidence to support its use.”
5) That said, it is actually NOT surprising. The EUA application of Remdesivir was actually submitted before the WHO’s large SOLIDARITY trial was published. But WHO sent it along to Gilead. Did Gilead withhold from FDA? https://twitter.com/drericding/status/1319773033448570882
6) Indeed, it’s possible FDA approval of Remdesivir for in-hospital COVID ignored world's biggest clinical trial data which showed no improvement in survival, progression to ventilation, or hospital discharge. Gilead likely didn't forward the data to FDA.
7) You can hear the clear concern in WHO’s chief scientist @doctorsoumya’s voice defending the strength of trial & making the timeline quite clear when Gilead first got SOLIDARITY data showing no benefit. Either Gilead withheld it from FDA—or the FDA knew.
8) Trial was first publicly reported on Oct 16th but, that’s already **3** full weeks after Gilead first got the main results privately from @WHO. So @GileadSciences knew & either failed to disclose to FDA, or FDA looked the other way. Which is it? Https://twitter.com/drericding/status/1316896605652635649?s=21
9) And who’s the most famous taker of Remdesivir? @realDonaldTrump. https://twitter.com/drericding/status/1312236806222622720
10) and the WHO’s Solidarity trial also checked Remdesivir in diff groups: young and old, Low and high risk. No group benefited significantly from it. Nothing. https://twitter.com/drericding/status/1316896957529423872
11) Read the detailed clinical summary of the anti-Remdesivir recommendation by WHO by @Brief_19 roundup. https://twitter.com/brief_19/status/1329818035096596481
