%0 Journal Article
%T Update on efficacy of the approved remdesivir regimen for treatment of COVID-19: a systematic review with meta-analysis and trial sequential analysis of randomised controlled trials.
%A Okoli GN
%A Reddy VK
%A Lam OL
%A Askin N
%A Rabbani R
%J Curr Med Res Opin
%V 0
%N 0
%D 2024 Jun 8
%M 38850519
%F 2.705
%R 10.1080/03007995.2024.2366443
%X <B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>Remdesivir appeared promising for COVID-19, but there is insufficient evidence of its efficacy. High quality RCTs are needed for a stronger evidence base.