Abstract：
UNASSIGNED: Efficacy of remdesivir for COVID-19 remains unclear. We updated our published systematic review to better inform on the use of remdesivir for COVID-19.
UNASSIGNED: We searched for randomised controlled trials (RCTs) among hospitalised COVID-19 patients. Meta-analysis was conducted using an inverse variance, random-effects model, presenting relative risk (RR) or mean difference (MD) and their associated 95% confidence intervals (CIs). Statistical heterogeneity was calculated using the I2 statistic. In addition, we conducted trial sequential analysis (TSA). Outcomes with additional data were clinical progression, hospitalisation days, and all-cause mortality.
UNASSIGNED: We included nine RCTs (12,876 individuals). Three trials each were of a low, unclear, and a high risk of bias. Compared with no treatment/placebo, remdesivir (100mg daily, over 10 days) significantly improved clinical progression (RR 1.06, CI 1.02-1.11), but did not significantly reduce hospitalisation days (MD -0.48, CI -2.18-1.21) and all-cause mortality (RR 0.92, CI 0.84-1.01). TSA suggested that further information is not required to conclude on the efficacy of remdesivir in improving clinical progression, and that, while more information is required for hospitalisation days and all-cause mortality, further RCTs to prove fewer hospitalisation days may be futile, as efficacy of remdesivir for this outcome is unlikely.
UNASSIGNED: Remdesivir appeared promising for COVID-19, but there is insufficient evidence of its efficacy. High quality RCTs are needed for a stronger evidence base.
UNASSIGNED: We searched for randomised controlled trials (RCTs) among hospitalised COVID-19 patients. Meta-analysis was conducted using an inverse variance, random-effects model, presenting relative risk (RR) or mean difference (MD) and their associated 95% confidence intervals (CIs). Statistical heterogeneity was calculated using the I2 statistic. In addition, we conducted trial sequential analysis (TSA). Outcomes with additional data were clinical progression, hospitalisation days, and all-cause mortality.
UNASSIGNED: We included nine RCTs (12,876 individuals). Three trials each were of a low, unclear, and a high risk of bias. Compared with no treatment/placebo, remdesivir (100mg daily, over 10 days) significantly improved clinical progression (RR 1.06, CI 1.02-1.11), but did not significantly reduce hospitalisation days (MD -0.48, CI -2.18-1.21) and all-cause mortality (RR 0.92, CI 0.84-1.01). TSA suggested that further information is not required to conclude on the efficacy of remdesivir in improving clinical progression, and that, while more information is required for hospitalisation days and all-cause mortality, further RCTs to prove fewer hospitalisation days may be futile, as efficacy of remdesivir for this outcome is unlikely.
UNASSIGNED: Remdesivir appeared promising for COVID-19, but there is insufficient evidence of its efficacy. High quality RCTs are needed for a stronger evidence base.
摘要：
■雷米西韦对COVID-19的疗效尚不清楚。我们更新了已发表的系统评价，以更好地了解雷德西韦用于COVID-19的情况。
■我们搜索了住院COVID-19患者的随机对照试验（RCT）。Meta分析使用逆方差进行，随机效应模型，呈现相对风险(RR)或平均差(MD)及其相关的95%置信区间(CI)。使用I2统计量计算统计异质性。此外,我们进行了试验序贯分析(TSA).额外数据的结果是临床进展，住院天数,和全因死亡率。
■我们包括9个RCT（12,876人）。三个试验都很低，不清楚,和偏见的高风险。与没有治疗/安慰剂相比，remdesivir(100mg每日,超过10天)显著改善临床进展(RR1.06，CI1.02-1.11)，但未显著减少住院天数(MD-0.48,CI-2.18-1.21)和全因死亡率(RR0.92,CI0.84-1.01).TSA建议，不需要进一步的信息来得出关于雷米西韦改善临床进展的疗效的结论，而且，虽然住院天数和全因死亡率需要更多信息，进一步证明住院天数减少的随机对照试验可能是徒劳的，因为雷米西韦对这一结果的疗效是不可能的。
■Remdesivir对COVID-19似乎很有希望，但没有足够的证据证明其疗效。需要高质量的RCT来建立更强大的证据基础。
■我们搜索了住院COVID-19患者的随机对照试验（RCT）。Meta分析使用逆方差进行，随机效应模型，呈现相对风险(RR)或平均差(MD)及其相关的95%置信区间(CI)。使用I2统计量计算统计异质性。此外,我们进行了试验序贯分析(TSA).额外数据的结果是临床进展，住院天数,和全因死亡率。
■我们包括9个RCT（12,876人）。三个试验都很低，不清楚,和偏见的高风险。与没有治疗/安慰剂相比，remdesivir(100mg每日,超过10天)显著改善临床进展(RR1.06，CI1.02-1.11)，但未显著减少住院天数(MD-0.48,CI-2.18-1.21)和全因死亡率(RR0.92,CI0.84-1.01).TSA建议，不需要进一步的信息来得出关于雷米西韦改善临床进展的疗效的结论，而且，虽然住院天数和全因死亡率需要更多信息，进一步证明住院天数减少的随机对照试验可能是徒劳的，因为雷米西韦对这一结果的疗效是不可能的。
■Remdesivir对COVID-19似乎很有希望，但没有足够的证据证明其疗效。需要高质量的RCT来建立更强大的证据基础。
