Galapapositief schreef op 26 april 2020 14:20:
Nee. Gaat niet om die trial. En ik vermoed dat u alleen de samenvatting heeft gelezen. Interessant om het hele onderzoek en de discussie te lezen.
Observatie 1: met name bij patiënten die bij de start van het onderzoek al aan een ventilator liggen ervaren de "forse" bijwerkingen. Zie bijlage voor het overzicht.
Observatie 2: Ga ik niet samenvatten, lees zelf maar:(..) regarding the safety and efficacy of remdesivir for Covid-19, the outcomes observed in this compassionate-use program are the best currently available data. Specifically, improvement in oxy-gen-support status was observed in 68% of patients, and overall mortality was 13% over a median follow-up of 18 days. In a recent randomized, controlled trial of lopinavir–ritonavir in patients hospitalized for Covid-19, the 28-day mortality was 22%. It is important to note that only 1 of 199 patients in that trial were receiving invasive ventilation at baseline. In case series and cohort studies, largely from China, mortality rates of 17 to 78% have been reported in severe cases, defined by the need for admission to an intensive care unit, invasive ventilation, or both. For example, among 201 patients hospitalized in Wuhan, China, mortality was 22% overall and 66% (44 of 67) among patients receiving invasive mechanical ventilation. By way of comparison, the 13% mortality observed in this remdesivir compassionate-use cohort is noteworthy, consid-ering the severity of disease in this patient popu-lation
Onderzoeksdisclaimer, vergelijken is niet zuiver:
however, the patients enrolled in this com-passionate-treatment program are not directly comparable to those studied in these other reports. For example, 64% of remdesivir-treated pa-tients were receiving invasive ventilation at base-line, including 8% who were receiving ECMO, and mortality in this subgroup was 18% (as compared with 5.3% in patients receiving noninvasive oxygen support), and the majority (75%) of patients were male, were over 60 years of age, and had coexisting conditions.