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Analyzing Remdesivir Resistance, 2 Years and Many Variants Later

Remdesivir was the first FDA-approved drug to fight COVID-19, but how has it held up against the latest variants?

As the first COVID-19 drug approved by the US Food and Drug Administration (FDA), Gilead’s remdesivir has been a focal point of the pandemic.

At the recent IDWeek 2022 conference, Anu Osinusi, Vice President, Clinical Research for Hepatitis, Respiratory and Emerging Viruses at Gilead, discussed ongoing research into the efficacy of remdesivir.

Osinusi discussed 2 categories of data she was presenting on behalf of Gilead. The first was a resistance analysis of the COVID-19 antiviral remdesivir, and the second was data collected from real-world studies.

On the resistance side of the study, the investigators were working to discover the frequency of emergence of resistant substitutions to the active site of the COVID-19 virus that remdesivir targets. When comparing the remdesivir and placebo cohorts, Osinusi and her team noticed something interesting.

They found that the substitutions were naturally emerging, meaning that participants developed resistance at similar rates, regardless of whether they received the drug. Notably, remdesivir was still active in patients with these substitutions.

“I think this was very good because it’s in keeping with what we’ve been able to generate through the start of the pandemic, across all the different Variants of Concern,” said Osinusi, “really telling us that remdesivir still continues to maintain a high barrier to resistance.”

Osinusi also highlighted a real-world study conducted by Gilead and the Veterans Administration. Among COVID-19 patients who required some low-flow oxygen, remdesivir reduced the risk of needing mechanical ventilation by 53% and the risk of death by 42%.

“This continues to tell us the story that 2 years into this pandemic, since the approval of remdesivir, it continues to play a pivotal role for health care workers that are treating hospitalized and non-hospitalized patients with COVID,” Osinusi said.

She emphasized that the next step is expanding the access of remdesivir to more patient populations. Additionally, “We’re also working very hard at developing an oral COVID nucleotide that will be used for the treatment of COVID-19 across the disease spectrum.”