Introduction: Several randomized clinical trials (RCTs) that investigated the effectiveness of remdesivir for the treatment of Covid-19 have generated inconsistent evidence. The present study aimed to synthesize available RCT evidence using network meta-analyses (NMAs).
Methods: Both blinded and open-label RCTs in PubMed database from inception to June 7, 2020 that contained “remdesivir”, “Covid-19”, and “trial” in the abstracts conducted on hospitalized Covid-19 persons were identified and screened. The studies must have at least one remdesivir arm and evaluated one of the pre-specified outcomes. The outcomes were clinical improvement between days 10-15 after randomization and clinical recovery during the follow-up period. The identified literature was supplemented with relatively recent studies that were known to the researchers if not already included. Frequentist NMAs with random effects were conducted.
Results: Both 10-day and 5-day remdesivir regimens were associated with higher odds of clinical improvement [odds ratio (OR) of 10-day regimen: 1.35, 95% confidence interval (CI): 1.09 – 1.67); OR of 5-day regimen: 1.81, CI: 1.32 – 2.45] and higher probabilities of clinical recovery [relative risk (RR) of 10-day regimen: 1.24, CI: 1.07 – 1.43); RR of 5-day regimen: 1.47, CI: 1.16 – 1.87] compared with placebo.
Conclusions: Remdesivir may have clinical benefits among hospitalized Covid-19 persons.