New Guidelines Recommend Remdesivir, But Not Other Drugs, To Treat COVID-19

The Infectious Diseases Society of America, one of the leading organizations in the U.S. for infectious disease management, released new guidelines for COVID-19 treatment and drugs being tested to treat the coronavirus.

Cleveland Clinic’s Dr. Adarsh Bhimraj, who led the panel that issued the revisions, said there is moderate evidence remdesivir, an antiviral medication, may be an effective treatment.

“So far, the main agent that showed some utility or some use is remdesivir,” said Dr. Bhimraj. “That’s because the ACT trial showed that remdesivir had decreased the length of symptoms, even though it did not show any mortality benefit yet.”

Bhimraj said the malaria drug hydroxychloroquine and convalescent plasma are not recommended for treatment, except in ongoing clinical trials. Both treatments show low evidence of effectiveness in studies so far, he said.

“We don’t want to stifle scientific progress,” Bhimraj said. “That’s why we said use in the context of clinical trials.”

Another update advises physicians on how and when remdesivir might be used in the event of a limited supply, “which is a situation we might run into pretty soon,” he said. “Then, maybe you can consider them in the patients who just need supplemental oxygen, rather than people who are on mechanical ventilations.”

The new guidelines also address famotidine, an antacid. Bhimraj said there is anecdotal evidence from China showing COVID-19 patients who took the drug had better outcomes, but the IDSA does not recommend the drug for coronavirus treatment at this time.

“This is a drug that is needed for proven indications by gastroenterologists,” he said. "Until we have trial data, we should not be using famotidine, at least for the treatment of COVID-19.”

A panel of doctors, scientists and infectious disease experts analyzed existing literature and results from clinical trials to create the guidelines.

The update, released June 22, is the first major revision to the coronavirus treatment guidelines, which previously came out in April.