Talk:Remdesivir/Archive 1

Archive 1

Expert attention please.

@Doc James:@Boghog: I came to the page after seeing mention of this drug in today's rapid update stream of the NYT. I found a sentence in the lead, citing a business-law periodical, claiming efficacy of the drug against the Wuhan coronavirus strain. Having not seen this in the scientific literature, I checked the source, and it did not support this claim:

Follow up studies have found antiviral activity in multiple coronaviruses... including 2019-nCoV,...

Even if it had, I did not view this source as an appropriate one for a scientific claim of efficacy, certainly not in the article introduction (which is featured by various search engines). As such, this claim for the Wuhan virus was hidden (for you to review), and a new sentence was crafted based on the New York Times report. The new statement, however, appears only in the lead, and is time-sensitive, and so further work by expert editors is needed to place it (and this source), or whatever you derive from it, whereve it should properly go. Cheers. 2601:246:C700:19D:8C9D:97A7:70F1:92C9 (talk) 18:22, 10 February 2020 (UTC)

It is important to keep in mind that activity ≠ efficacy. The lead currently only states that there is activity and says nothing about efficacy. The cited reference reports activity in cell cultures and mouse animal models. Furthermore the lead makes clear that remdesivir is currently undergoing clinical trials. One can say nothing about efficacy in humans until the results of the clinical trials have been reported. So perhaps the lead could be edited to make this distinction clearer, but in my opinion, it does not mislead. Boghog (talk) 19:37, 10 February 2020 (UTC)

Adjusted to say it is being studied. Doc James (talk · contribs · email) 05:34, 11 February 2020 (UTC)

Yup, we should really lose the entire sentence "Based on success ..." in the lede. There is undue weight a single treatment and it reads as an advertising plug. We could leave the references to qualify the previous statement. -- TerryE (talk)

Wrong JSMOL image

From IP 31.10.40.210:

Note JSMOL image shows completely wrong sugar moiety in 3d representation (lyxo rather than ribo) - also the CH2O group on the sugar should be on opposite side as the CN.

--ἀνυπόδητος (talk) 11:44, 28 February 2020 (UTC)

Remdesivir

• ... is a trade NAME, not a systematic chemical name. So capitalization required. Odore di spirito adolescenziale (talk) 12:34, 17 April 2020 (UTC)

• No, it's an international nonproprietary name, so not a trade name: https://www.who.int/medicines/publications/druginformation/innlists/PL116.pdf (p 667). Best, ἀνυπόδητος (talk) 16:35, 17 April 2020 (UTC)

• User:Anypodetos is correct Doc James (talk · contribs · email) 18:49, 17 April 2020 (UTC)

• "Remdesevir" is indicated as a "generic name" on the FDA's Drug Designations and Approvals listing (link), and is not capitalized in Gilead's own marketing materials (link) --Dystopos (talk) 19:19, 17 April 2020 (UTC)

• It is on the recommended INN list https://www.who.int/medicines/publications/druginformation/innlists/RL78.pdf Whywhenwhohow (talk) 21:50, 17 April 2020 (UTC)

NEJM publication of April 10, 2020 regarding compassionate basis treatment

For those of you with editing power, I suggest adding information to the covid-19 section as to the said publication, which is a "preliminary report describes the clinical outcomes in a small cohort of patients who were severely ill with Covid-19 and were treated with remdesivir."

It's uncontrolled results (and it's Gilead supported), but may be valuable information in these hectic days, as for the following:

Due to the nature of the treatment no virus load data was collected (so these specific results do not confirm the antiviral effects of remdesivir). However, for the moment, "...the outcomes observed in this compassionate-use program are the best currently available data. Specifically, improvement in oxygen-support status was observed in 68% of patients, and overall mortality was 13% over a median follow-up of 18 days."

https://www.nejm.org/doi/full/10.1056/NEJMoa2007016?query=RP https://www.bloomberg.com/news/articles/2020-04-10/two-thirds-of-severe-covid-19-improved-on-gilead-s-remdesivir https://www.bloomberg.com/news/articles/2020-04-10/two-thirds-of-severe-covid-19-improved-on-gilead-s-remdesivir

The quotes are taken from the NEJM article. Stay safe. Michal. 188.64.206.106 (talk) 17:26, 12 April 2020 (UTC)

We generally wait for secondary sources. A uncontrolled trial with COI is not that notable.

We have a decent review here https://emcrit.org/pulmcrit/pulmcrit-eleven-reasons-the-nejm-paper-on-remdesivir-reveals-nothing/ Doc James (talk · contribs · email) 18:58, 14 April 2020 (UTC)

"In April 2020, the outcome of a compassionate use scenario in which several dozen patients received the drug for ten days was reported in The New England Journal of Medicine; the conclusion was that a modest majority (68%) showed improvement as a result of treatment."

This is a primary source. We should wait for a secondary one. The study did not show improvement due to treatment. It cannot as it was not designed to show effect. Doc James (talk · contribs · email) 02:51, 15 April 2020 (UTC)

@User:Doc James - I saw Your edit of April 15, and I read the explanation you left here, and I must say I was not convinced. There are times when some information, limited as it may be, is better then none (times in which what we generally practice, may not apply). As the publication is clear about the limited scope of the results published (and I, in my turn, made that clear when I added that information in my edits, both here and on the relevant Wikipedia article), then to my mind it is worthy of mentioning, alongside the (mere) fact that some clinical trials are being conducted as well (especially since the general public who seeks nowadays condensed information about these subjects, via the Wikipedia, is not exposed to reviews like the one you referred to above). As I said to begin with, even limited scope results may be valuable information in these hectic days. In any case, it's not my habit to go into edit-wars (of any kind), so I'll leave it at that. Cheers. Michal.188.64.207.76 (talk) 00:58, 16 April 2020 (UTC)

• I suppose one question is whether the EndPoint News article would be a preferred citation than the NEJM one. In adding the article, I put the EndPoint News article link as the Lay Summary, which I likely should not have done; rather maybe should have separated into two citations included in a single ref-tag set? I bring this up as the early comments above relate to primary vs. secondary sources. --User:Ceyockey (talk to me) 02:08, 16 April 2020 (UTC)

@User:Ceyockey - From what you write above I understand it was you who added the link to the Endpoint article. If so, thanks for clarifying that. You didn't sign your edit as well, so there was no way to notice that (I thought that was part of User:Doc James's comment). Anyhow, I am not of medical background, and I'm not even sure what source can be considered as a "secondary" source in this case (being a jurist and a lawyer, the mere notion of preferring a secondary source to a primary source - for reference purposes, is counter-intuitive for me). As User:Doc James "trimmed" out all the information about the compassionate basis treatment results, I don't see a point in re-editing it while adding the second source you suggested (which is actually, a third source. A Bloomberg article was originally linked as well. Maybe not of the same scientific value, but as a lay summery I thought it would suffice...). Thanks for commenting. Michal. 188.64.207.76 (talk) 12:15, 16 April 2020 (UTC)

@User:188.64.207.76 (Michal) -- didn't sign my edit? My username is clearly in the History log for the article ... and I most certainly did sign my comment above. --User:Ceyockey (talk to me) 01:22, 17 April 2020 (UTC)

Well, you didn't (sign the comment in question, which is not the one above, but the one in which a quote from the Endpoint article was added). Since that comment was added in the middle of Doc James' comment, I didn't think I should look into the History log for it's origins. This was obviously some mishap, the kind of which happens here and there to all of us. No insult was suggested, and I hope none was taken. I'm not here to pick a fight. Cheers. Michal.188.64.207.76 (talk) 01:59, 17 April 2020 (UTC)

@User:Ceyockey just wanted to note that while looking today at the History log of the main article, I found that a few days ago User:Doc James moved some edit you made from the main article to the talk page, and I suspected that's where the mish-mash in the comments began. Sorry for the misunderstanding. Michal.00:20, 18 April 2020 (UTC)46.19.86.219 (talk)

If we are going to add that NEJM article we also need to discuss all the limitations of it as done here.https://emcrit.org/pulmcrit/pulmcrit-eleven-reasons-the-nejm-paper-on-remdesivir-reveals-nothing/

The popular press generally over promotes stuff and the NEJM is a primary source so we could just leave it out until covered by a proper review (which will likely only be a couple of more days). Doc James (talk · contribs · email) 19:35, 16 April 2020 (UTC)

+1 --User:Ceyockey (talk to me) 01:24, 17 April 2020 (UTC)

@User:Doc James - I appreciate your engagement, but respectfully disagree. This is not a scientific publication, this is the place for ordinary people to get fair information on the subject at hand, and as long as that information is presented accurately, and is supported with sources that enable the reader to further explore the given information (if he so wishes), to my mind that's more than enough. Especially regarding the COVID-19 issue, about which the information is collected, examined and reported nowadays on the fly (due the unusual circumstances). When noting that some clinical trials are taking place, you don't need to discuss the meaning of that, and surely won't explain the reader that having a trial doesn't imply getting any results. You trust even the lay reader to understand that himself (with or without the need to explore that). The same applies in this case. The edit I made merely informed the reader that some limited results were published in an established journal (which is a fact and a relevant one, no less than the facts that mention the ongoing clinical trials). The published results were not mentioned in the main article but in The footnote wherein the source was linked, and only after the main caveats were clearly mentioned (including the fact that no data was collected as to the antiviral effects of drug). That should be more than enough for the reasonable lay reader to understand how limited scoped are the results (as I mentioned above, I myself am such a lay reader, when it comes to medical issues, and I grasped that). And yet, the reader gets to know about it, while under your approach the information is totally purged and a reader seeking for information would not know about it at all (a couple of days, these days, could be a lot of time).

As for the popular press as a reasonable source, I'm aware of the medical professionals point of view on the subject, but suggest we shouldn't think and judge in generalizations either. I'm not at all acquainted with the Bloomberg news website. However, to my mind, they did exactly what you thought should be done in order to put the NEJM publication in perspective (for a lay reader to understand its results), and I quote: '...Some scientists have expressed skepticism with regard to the results. The data from this paper are almost uninterpretable,” Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said in an emailed statement. “There is some evidence suggesting efficacy, but we simply do not know what would have happened to these patients had they not been given the drug"...'

'We simply don't knows' seems to be the most common comment of the professionals these days (and it's completely understandable. Lots of Tera Incognita, nothing is certain yet). However, that can't be a reason for not publishing, exploring and trying to make sense of all that information which is not yet certain. Michal.188.64.207.76 (talk) 23:08, 16 April 2020 (UTC)

We need to present it fairly. Yes the conclusion is that we do not know and that paper does not change that. Doc James (talk · contribs · email) 00:26, 17 April 2020 (UTC)

OK, and while we split hairs, here comes another one (from the Chicago clinical trials, which are uncontrolled as well, if I understood correctly) - Early peek at data on Gilead coronavirus drug suggests patients are responding to treatment: "In scientific terms, all the data are anecdotal until the full trial reads out, meaning that they should not be used to draw final conclusions. But some of the anecdotes are dramatic.". Too bad a Wikipedia reader would not be able to get any information about that, even if he/she looked for it (which is how I happened to find myself in this debate to begin with). BTW, I wasn't looking for additional information on the subject, I just stumbled upon a headline about it the Washingtonpost. Anyways, let's hope something good will come out of it, to the merits. Michal. 188.64.207.76 (talk) 01:09, 17 April 2020 (UTC)

"Clinical improvement was observed in 36 of 53 hospitalized patients with severe COVID-19 treated with compassionate-use remdesivir."

We really do need secondary sources. Let me look for some. Doc James (talk · contribs · email) 18:35, 17 April 2020 (UTC)

Adjusted to "While a cohort study published in April 2020 saw possible improvement, determining whether or not the medication is effective is going to require a randomized controlled trial." Doc James (talk · contribs · email) 18:49, 17 April 2020 (UTC)

@User:Doc James - I'm not sure what you meant by quoting from the "primary" NEJM publication as above, but I did see both your edits of today, and they are fine with me... (eventually you went even further than I originally suggested, as to describing the compassionate-basis results). I also saw that others have already edited the relevant section of the COVID-19_drug_repurposing_research article (some of the wordings are not appropriate to my mind, but I'm not going to chime in, as the subject became even more sensitive (stock value implications, etc.) I assume you'll trim them out in due time :-). I'm glad you find the way to do it your way (and tks for that JH reference, which was helpful in another issue). It started really feeling strange having this debate, when an item about the Chicago trials found its way to one of our (Israel) national radio news headlines today. Thanks for the updates and the whole dialog. Sometimes not agreeing can be productive as well. Lets hope we shall not be disappointed. Michal. 46.19.86.219 (talk) 00:20, 18 April 2020 (UTC)

References

Citations to clinical trials

@Whywhenwhohow: The advantage of {{ClinicalTrialsGov}} over {{cite web}} is that the former is more compact and if the ClinicalTrialsGov link changes, it is easily changed in one template compared to the thousands of transclusions of the {{cite web}} template that might have to be changed. The only thing that {{ClinicalTrialsGov}} lacks that {{cite web}} contains are |date= and |access-date=, but why are these even necessary? The citations themselves contain the initiation date. If you insist, these could easily be added to the {{ClinicalTrialsGov}} template. Also why would you not want to include a link that provides an uptodate list of clinical trials? Otherwise we will have to constantly update this list.

References

Boghog (talk) 17:53, 20 April 2020 (UTC)

@Boghog: A dynamic search result is not a reliable source. The results of the search change and do not reflect the point-in-time source that was used for the article text. It assumes that the search API will not change. Looking at the search results in more detail trial #7 (NCT04335123) included in the search results appears to be a trial of losartan, not remdesivir. Looking at each clinical trial and adding it as a source is more reliable than a dynamic search result that may or may not be relevant when viewed later. A dynamic search result is not useful as a reliable source when the page is printed and read offline.

The following edit to the template documentation for {{ClinicalTrialsGov}} added the notice that it shouldn't be used for reliable sources https://en.wikipedia.org/w/index.php?title=Template:ClinicalTrialsGov/doc&oldid=666398699. In general, the initiation date of a trial may not be related to the text in the article. The {{ClinicalTrialsGov}} template is missing the access-date and it does not require the title.

Whywhenwhohow (talk) 21:20, 20 April 2020 (UTC)

@Whywhenwhohow: A dynamic link is a reliable source to document that there are/were at least x number clinical trials underway at the time the source was added. That number will grow or stay the same over time, it will never shrink, so that the link will always be correct. I agree that is better if the title is included in the source, but to claim that a source is not reliable if a title is not included is not supported by any Wikipedia policy or guideline that I am aware of. No hyperlink is useful when printed and read off line, not just this one. Even from the printed version, one can type the NCT number into a search engine in a web browser and quickly find a link to the trial. The minimum requirement to establish the reliability of a source is to include enough information so that someone can locate the original source, and for the purpose the NCT number alone is sufficient. I will work on adding a date parameter to {{ClinicalTrialsGov}}. Boghog (talk) 03:06, 21 April 2020 (UTC)

@Boghog: A full citation is preferred as well as including a title. The {{cite web}} template requires a title -- This parameter is required and will generate an error if not defined. Providing the title improves the consistency of the citations. WP:CITETYPE, WP:CITEWEB Whywhenwhohow (talk) 03:32, 21 April 2020 (UTC)

@Whywhenwhohow: As I already stated above, I agree that a title should be included and {{ClinicalTrialsGov}} supports titles. Furthermore I always include titles when using this template. So it is not appropriate to use this template even if a title is included because someone else might not include the title somewhere else? This makes no sense. Boghog (talk) 17:11, 22 April 2020 (UTC)

{{ClinicalTrialsGov}} is transcluded into 336 articles. Out of those, only 15 used the template without a title. The later number has now been reduced to to zero. Boghog (talk) 19:40, 22 April 2020 (UTC)

Cost and availability?

Both are of current (April 29, 2020) broad general interest. CCN.COM claims a Wall Street analyst suggested the treatment cost would be between US$50 and 100. Gilead is limiting distribution in Canada and cites its limited availability (limited manufacturing capacity). I'd prefer better sources of information. I'm sure there will be additional information forthcoming from Gilead, since it will be under tremendous pressure (and in the spotlight of global interest/hysteria...). What is needed is 1. comparative cost of manufacture (actual street price will be set by other factors, both by the company and by the country it is selling into). 2. Current manufacturing capacity 3. Likely manufacturing capacity in 3 months, 6 months, 1 yr.174.130.70.61 (talk) 19:57, 29 April 2020 (UTC)

I think it is way too premature to talk about costs, especially since it has not been approved for use. Remdesivir is a relatively complex small molecule therefore the cost of goods will be rather high. On the other hand, Gilead will be under intense pressure to keep costs reasonable and governments could very well step in to regulate and/or subsidize the cost. The supply question is interesting and apparently Gilead is already scaling up the synthesis and they estimate that they currently have enough drug for 140,000 treatment courses, 500,000 courses by October, and 1 million courses by the end of the year. Boghog (talk) 20:56, 29 April 2020 (UTC)

References

Concur with Boghog. Also, Josh Bloom at ACSH was blogging a month ago about how manufacturing remdesivir at scale would be a nice problem to have, if the drug actually works. He explains in plain English what kinds of problems Gilead's process chemists are probably trying to solve right now. Apparently the biggest obstacles are that some of the ingredients are toxic and can't be safely mixed at room temperature (which is why Gilead's published articles talk about mixing them at subzero temperatures), and the current manufacturing process involves at least 6 separate applications of HPLC to separate and purify intermediate compounds. HPLC is difficult to scale up for mass production. --Coolcaesar (talk) 23:57, 29 April 2020 (UTC)

Looks like Gilead anticipated the anonymous editor's thoughts above. STAT News just published an edited transcript of an interview with Gilead CEO Daniel O'Day which touches on issues of availability and cost. --Coolcaesar (talk) 00:08, 30 April 2020 (UTC)

Not sure where to add information about Gilead's patent to the article

I don't normally edit pharmaceutical articles on Wikipedia, so I don't know where to add this to the article, but I thought I should mention this in case someone knows. The relevant Gilead patent on remdesivir (U.S. Patent No. 10,251,904 B2) is available here from Google Patents. The PDF version of the patent is available here from Google Patents. Notice how the patent first claims an invention in the form of a family of compounds to treat Arenaviridae infections, then turns around and also claims the same compounds can treat Coronaviridae infections. --Coolcaesar (talk) 18:22, 29 April 2020 (UTC)

The synthesis section might be the best place to mention this. There is already one patent mentioned there. In addition, there is a Chinese use patent mentioned at the end of the COVID-19 section. There are undoubtedly a number of patents including composition of matter, formulation, and uses covering different indications. Boghog (talk) 20:19, 29 April 2020 (UTC)

Here is a list of Glead patent applications where remdesivir is specifically mentioned. Boghog (talk) 05:53, 30 April 2020 (UTC)

References

Large study showed benefit

Dr Fauci announced today that a large randomized controlled study shows it has a definite positive effect, decreasing the time to recovery from 15 days in the placebo group to 11 days in the Remdesivir group, p<.001. I heard him at the press conference and he seemed to be saying it should be the standard of care. The fatality rate was 8% with Remdesivir, compared to 11% with placebo, but not significant. Not published yet, not peer reviewed. At what point can this be mentioned in the article? Medical practice may not wait for Wikipedia editors to be satisfied with the quality of available secondary MEDRES references before they use it in treatment. I would expect we would want written references, not just a verbal summary, with notation of any weaknesses of the study, or and bad effects such as kidney damage. Edison (talk) 17:17, 29 April 2020 (UTC)

Concur with above especially the last sentence. NIAID just released a bare-bones press release with some data, but it may not satisfy WP:RS. --Coolcaesar (talk) 18:09, 29 April 2020 (UTC)

Things are moving fast. Based on this clinical trial, it appears that the FDA is going to grant emergency use authorization as early as today. Hence I have mentioned the trial in this edit. Given it is mentioned along with another trial that did not show benefit, I think it is justified to mention this result. If and when the emergency use authorization is granted, we can mention that as well. Boghog (talk) 20:14, 29 April 2020 (UTC)

References

A press release is obviously not a WP:RS, especially one as bare-bones as this one. Gary Schwitzer has a critique of the press coverage on his blog [What the public didn’t hear about the NIH remdesivir trial], and he incidentally discusses some of the problems with the trial they reported -- and these are WP:RS, though not WP:MEDRS. Most notably, "primary endpoints or outcomes were shifted by the researchers in the NIH trial just within the past two weeks. Fauci didn’t acknowledge that in his upbeat pronouncement." The original primary endpoint included death. The new endpoints are "time to recovery." Some of the news stories are asking, "What's the benefit of this drug if it has no effect on survival?" --Nbauman (talk) 21:27, 1 May 2020 (UTC)

If patients are on average released earlier from overcrowded ICUs, then this drug may at least indirectly save lives. Boghog (talk) 03:37, 2 May 2020 (UTC)

Ordering

IMO we should have the most recent first rather than the oldest first. Doc James (talk · contribs · email) 23:01, 23 April 2020 (UTC)

Yes, I agree that reverse chronological order for the time being makes sense. If and when remdesivir is approved for use, then it might make sense to have a separate history/discovery section in chronological order, but not now. Boghog (talk) 10:34, 24 April 2020 (UTC)

I disagree, and I don't see why it makes sense to do this. Smells like recentism to me (as of now, when it remains a drug in search of a disease to treat, and COVID is just the latest possibility that hit has yet to be found effective against). Agricolae (talk) 16:08, 24 April 2020 (UTC)

There may have been a slight misunderstanding above. Doc James swapped the order of Ebola and COVID-19. The drug was not effective for treating Ebola and the jury is still out for COVID-19. Obviously a treatment that might work is more important than one that does not work. For COVID-19, the most recent clinical results are the most significant and that is what most readers would probably want to read first. Once there is more definitive results for COVID-19, then a separate historical section in chronlogical order would be appropriate. Boghog (talk) 18:43, 24 April 2020 (UTC)

No, no misunderstanding whatsoever, just a complete disagreement over the logic of which order 'makes sense'. Until we know otherwise, COVID is just another virus against which there is no solid evidence of the drug working in vivo, and it is nothing but recentism to present it as 'a potential COVID drug that historically failed for another virus' as this ordering of your proposed historical section would imply, as opposed to what it is: an antiviral still in search of a disease it is effective against. Agricolae (talk) 21:20, 24 April 2020 (UTC)

We generally use reverse chronological order for healthcare. It is also why we put the history section near the end of the article.

May as well list them alphabetically than. Doc James (talk · contribs · email) 00:13, 25 April 2020 (UTC)

Per WP:DUE people care a great deal more about the recent interest in this medication than what occurred back in 2015 and did not pan out. Thus it makes more sense to put COVID19 first. Doc James (talk · contribs · email) 07:45, 2 May 2020 (UTC)

Chirality

It seems to me that the ball & stick model is incorrect at some points when it comes to chiral orientation. Compare https://pubchem.ncbi.nlm.nih.gov/compound/Remdesivir#section=3D-Conformer Simon de Danser (talk) 04:54, 18 May 2020 (UTC)

In general I think it's more likely that PubChem is wrong - they compute conformations using an unspecified algorithm, whereas the ball and stick model is determined experimentally. If you click on the image and navigate to its description on Wikimedia Commons, it has the references: CSD entry ZARNAK, from J. Med. Chem. (2017) 60, 1648-1661. However, comparing the chiral centres in the skeletal formula, the ball-and-stick model and the PubChem model one by one, they look consistent to me. --Ben (talk) 21:51, 26 May 2020 (UTC)

Side effects

Seems like this page would benefit from a section discussing them. TylerDurden8823 (talk) 07:19, 22 April 2020 (UTC)

Unfortunately it appears that it is to soon to include anything about side effects. PMID 31774950 reports a phase II trial in treating Ebola infections with remdesivir. This study reports few if any serious drug related side effects. However this source is primary. It will be some time before the current clinical studies have been concluded and have been reviewed. Boghog (talk) 20:04, 22 April 2020 (UTC)

@TylerDurden8823 - "QT-interval prolongation" as a side effect of Remdesivir itself? I looked at the source you referred to (and its source as well), and though I see the recomendation not to use it "...in conjunction with hydroxychloroquin due to an increased risk of QT prolongation and fatal dysrhythmia" (ss 3.2 page 2), Table 2 (page 3) does not attribute such a side effect to Remedesivir itself (in contrast to information mentioned as to Lopinavir/ritonavir (QT prolongation) and Chloroquine+Hydroxychloroquine (Fatal dysrhythmias)). I suggest recheking that point, and reediting that paragraph. Michal. 46.19.86.244 (talk) 16:57, 1 May 2020 (UTC)

Reread and you're right. It's fixed, thanks. TylerDurden8823 (talk) 19:39, 1 May 2020 (UTC)

Thanks for checking that out and advising. Michal. 46.19.86.244 (talk) 22:55, 1 May 2020 (UTC)

@TylerDurden8823 - Sorry for the quibble, but the current wording of the paragraph looks somewhat problematic. Saying it is not recommended to combine Remdesivir with "other QTc-prolonging medications" implies that Remdesivir is one of those medications. Which is not the case (as far as we know, based on that quoted source. Though I must admit that the 'no combination' caveat is confusing. It is repeated, in a different wording, in the c note of Table 1. Which is odd. I'm not of a medical background, so I can't think of a way to clarify that. Maybe Doc James could help?). Michal. 188.64.207.233 (talk) 01:42, 2 May 2020 (UTC)

I've adjusted it. Credible Meds seems to indicate that there's no clear evidence one way or the other about QTc prolongation specifically for remdesivir. So, it's unknown. My guess is there may be a drug-drug interaction and that's why they're recommending avoiding it in combination with hydroxychloroquine based on the reference cited in that article here [1]. There's no need to recruit other editors for such a minor adjustment. Thanks for bringing this to my attention. It's also okay if you adjust something if you seem something that needs it, especially something that minor. Cheers. TylerDurden8823 (talk) 02:02, 2 May 2020 (UTC)

@TylerDurden8823 - There is no drug-drug interaction between Remdesivir and Chloroquine+Hydroxychloroquine, according the source's source either. I've checked and mentioned that in my original comment, and double checked that after your answer (see the Covid-19 Antivirals table on page 3 in the interaction summery of April 9, 2020; see the Covid-19 Antivirals interaction table in page 15 of the elaborated interaction document of April 9, 2020). That's why I thought the double caveat in the source article was odd, didn't regard it as a minor issue and thought a second opinion could be helpful. In any case, the more I look into it, the more it looks like an error to me. Looking at these interaction tables, it is clear that an alert of an QT risk interaction exists between Lopinavir/ritonavir and Chloroquine+Hydroxychloroquine. My guess is that the caveat in the article source was meant to warn of that combination, and the mentioning of Remdesivir in that context is a plain mistake. In a time the FDA issues an emergency use authorization for Remdesivir, There should be a way to clarify and correct that (is it practical to try and address one of the authors or the journal? just a thought). Michal. 188.64.207.233 (talk) 05:11, 2 May 2020 (UTC)

Indeed, I'll remove the sentence for now since I did a deeper dive on that source and it does not say remdesivir interacts in any clear way (doesn't mean it doesn't, but there's no clear evidence that it does at this stage so I agree it's strange the cited review cites the Liverpool page to suggest that it does). TylerDurden8823 (talk) 05:54, 2 May 2020 (UTC)

Just to let you know - I have written a mail to the Corresponding author of the said article, raised the question and referred him, inter alia, to this discussion. I can only hope he would see fit to comment, maybe even directly in this space. Thanks for joint effort to clarify this issue (I do believe it's very important these days for lay people, like myself, who look for information about the pandemic). Michal. 188.64.207.233 (talk) 06:54, 2 May 2020 (UTC)

@TylerDurden8823 - Got a thorough answer from Dr. Pourmand (the corresponding author of the article). Asked for a permission to publish it here. I will update when he replies. Michal. 188.64.206.71 (talk) 23:45, 4 May 2020 (UTC)

@TylerDurden8823 - Unfortunatly, I didn't get a permission to publish in verbatim the answer I recieved to the email I sent regarding the Remdesivir+Hydroxychloroquine/Chloroquine caveats in the said article (the corresponding author politely explained that due to copyright issues and other obligations towards the journal, an official response on that subject will be given when a letter to the editor is recieved. I've been wondering whether my email could qualify as a trigger for such a letter to the editor process, but I would leave it at that).

However, the corresponding author did affirm the sharing of some referrals he mentioned in his answer (yet, the following descriptive wording is mine) -

a. The fact that one of the Key Exclusion Criteria under Remdesivir's Clincal Trials conditions, stipulates as follows: "Concurrent treatment with other agents with actual or possible direct acting antiviral activity against SARS-CoV-2 is prohibited < 24 hours prior to study drug dosing".

b. The article SARS-CoV-2, COVID-19, and inherited arrhythmia syndromes, which was recentley published in the Heart Rhythm Journal, which states, among other things, the following (under ss C.1. LOTS and COVID-19): " However, both chloroquine and hydroxychloroquine are metabolized by CYP3A4, and COVID-19 treatment with (hydroxy)chloroquine can be combined with additional antiviral treatments such as ritonavir plus lopinavir (both potent CYP3A4-inhibiting drugs; their combination is associated with QT prolongation), azithromycin (besides being a macrolide antibiotic, it is investigated for its antiviral properties, with also (weak) CYP3A4 inhibition and associated with QT prolongation),25,26 or remdesivir (an investigational drug for which metabolism and possible QT-prolonging effects are not yet resolved). Combining (hydroxy)chloroquine with these drugs might thus result in higher plasma levels and significant QT prolongation. Hence, we advise monitoring QT intervals and cardiac rhythm if initiating these drugs given the increased risk of malignant arrhythmias (Figure 1)."

c. The following recent papers published in JAMA Network, which presents information regarding the use of Hydroxychloroquine/Chloroquine treatments during the ongoing COVID-19 pandemic -

Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19); published in JAMA Network on May 1, 2020;

Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care Unit; published in JAMA Network on May 1, 2020.

_____

To my general understanding, the caveats in the said article were meant to reflect the same cautious lines of thought which are manifested in (and/or should be concluded from) the accumulated sources mentioned above. In any case, I'm not sure to what extent the information from the sources mentioned above could be used to improve the Rmdesivir article (and would leave it to the discretion of those of you with the medical background). I hope it would at least help to resolve some of the questions we raised in the discussion above. Cheers. Michal. 188.64.206.71 (talk) 03:41, 7 May 2020 (UTC)

Noting that I've added the info as to the caution required regarding the combination of (hydroxy)chloroquine drugs with CYP3A4-inhibiting drugs and/or untested drugs (as recommended in the article from Heart Rhythm Journal, I was referred to as mentioned above), to the COVID-19_drug_repurposing_research#Chloroquine/Hydroxychloroquine article, as I didn't see any mention of that specific point in any of the (hydroxy)chloroquine articles (might be especially relevant due to the recent public re-interest in the (hydroxy)chloroquin as a claimed covid-19 treatment, and the trials that use a combination of these drugs with Azithromycin (some of which do have problematic side effects results as the two JAMA papers above reflect)). Michal.188.64.207.142 (talk) 00:59, 22 May 2020 (UTC)

Sorry for not logging in, but could anyone clarify why the "Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A, et al. (April 2020). "Compassionate Use of Remdesivir for Patients with Severe Covid-19" article is an "unreliable medical source"? If it really isn't good science, then why is it still being used as a source? Sorry, but professionally I am not really in a position to evaluate the resource. -Sam — Preceding unsigned comment added by 64.129.121.111 (talk) 17:15, 30 May 2020 (UTC)

I think that reading the study along with WP:MEDRS ought to answer your question. It's a quite underpowered study without any controls, blinding or random assignment (and conducted on behalf of the company that makes the drug). Basically, it says that 61 people who were quite ill with COVID-19 were given varying doses of remdesivir; some improved; some died; some recovered. The "Statistical analysis" section is quite certain that clinically significant conclusions can't be drawn from the study. That is pretty much what we consider an "unreliable medical source" – we can't use it to support medical statements. To be clear: we don't need to evaluate the source (nor should we); it is sufficient to identify it as one of the lowest quality of sources (primary, non-RCT study) and reject it per MEDRS. --RexxS (talk) 18:17, 30 May 2020 (UTC)

USA purchase

Should there not be a section on the moral implications of the US government buying up virtually all of the doses of this drug?

The argument is that "the US move to buy up so much stock [..] undermines international co-operation on Covid, given that other countries have taken part in trials of remdesivir". And that it "clearly signals an unwillingness to co-operate with other countries and the chilling effect this has on international agreements about intellectual property rights".

Also of note is controversy about the purchase price: "Some in the US have criticised the purchase price, as taxpayer money had helped fund remdesivir's development." --82.21.97.70 (talk) 23:26, 1 July 2020 (UTC)

Semi-protected edit request on 9 July 2020

Change "treatement" to "treatment" Boneill428 (talk) 02:47, 9 July 2020 (UTC)

Change made Whywhenwhohow (talk) 02:57, 9 July 2020 (UTC)

B-Class

These are the accepted B-class criteria:

B

The article is suitably referenced, with inline citations. It has reliable sources, and any important or controversial material which is likely to be challenged is cited. Any format of inline citation is acceptable: the use of <ref> tags and citation templates such as {{cite web}} is optional. The article reasonably covers the topic, and does not contain obvious omissions or inaccuracies. It contains a large proportion of the material necessary for an A-Class article, although some sections may need expansion, and some less important topics may be missing. The article has a defined structure. Content should be organized into groups of related material, including a lead section and all the sections that can reasonably be included in an article of its kind. The article is reasonably well-written. The prose contains no major grammatical errors and flows sensibly, but does not need to be of the standard of featured articles. The Manual of Style does not need to be followed rigorously. The article contains supporting materials where appropriate. Illustrations are encouraged, though not required. Diagrams, an infobox etc. should be included where they are relevant and useful to the content. The article presents its content in an appropriately understandable way. It is written with as broad an audience in mind as possible. The article should not assume unnecessary technical background and technical terms should be explained or avoided where possible.

For this article:

• B1: There instances of content relying on preliminary or low-quality sources.
• B2: The COVID-19 research section is speculative and has content based on original research. Some of the content is only present in the lead (e.g. administration).
• B3: The Research and Access sections overbalance the rest of the article. There is no section on uses (indications), contraindications, or many of the other sections advised by Wikipedia:Manual of Style/Medicine-related articles #Drugs, treatments, and devices.
• B4: The prose is sometimes choppy, but grammatical.
• B5: There is a minimal amount of supporting materials.
• B6: The lead is understandable to a lay audience. Some of the more detailed content is necessarily specialised.

I don't believe the article is B-class yet. --RexxS (talk) 22:30, 11 July 2020 (UTC)

@RexxS: You raise some valid points. I changed it back to C-class pending improvement and discussion here. Whywhenwhohow (talk) 22:51, 11 July 2020 (UTC)

It's difficult to get an article to B-class or GA when there are new sources coming out all of the time and the content is being continually revised. It's possible to make some improvements like adding extra sections per MOS:MED and sorting out the balance between lead and body of the article, but the research section is unlikely to settle down, and we really need to collect together the decent secondary sources to extract a section describing its accepted uses against COVID-19. That would allow the research section to be slimmed down. --RexxS (talk) 23:11, 11 July 2020 (UTC)

Citation style

We have a guideline WP:CITEVAR that requires prior consensus to change the existing style of citations. This article was developed and remained stable from 2016 to this year using what we may call "Chicago style", where authors are listed in this style: "Warren, T. K.; Jordan, R; Lo, M. K.;" etc. This year it was changed to a "Vancouver style" ("Warren T, Jordan R, Lo M," etc.) without discussion and then changed back to Chicago yesterday and then to Vancouver today. I've just reverted the last change and I hope we can settle on a style, either the stable style ("Chicago") per CITEVAR, or a different style ("Vancouver") if consensus can be found for the change per CITEVAR. --RexxS (talk) 13:03, 18 July 2020 (UTC)

The first major contributor to this article was Meodipt who established the Vancouver style. The style was then changed without discussion by Anypodetos/Citation bot. (Citation bot does not have the capability to add Vancouver style authors, hence this change by Anypodetos may not have even been deliberate. His main intention was probably just to template the cites.) Meodipt added a few additional citations also in Vancouver style, and these were also changed without discussion. When I converted it back to the original citation style in January 2020, most of the citations were from Meodipt.

Some of the author lists in this article are ridiculously long and it becomes even more ridiculous when the author data is stored with verbose |first1=, |last1=, ... parameters. What is the purpose including first authors in a citation, especially when citations include numerous links to other sources that contain the full author information? More is not necessarily better. More critical parts of the citation like the title start to get lost in the clutter when full author names are displayed. |vauthors= produces cleaner, more compact author lists and insures that the authors are formatted consistently. In contrast |first= places few restrictions on the way first names are displayed. Boghog (talk) 14:31, 18 July 2020 (UTC)

The first major contributor to the article, Meodipt, used a mix of styles: 26 November 2016. These hand-coded references used authors in "first name, last name" format as well as in "last name, initial". The first consistent, templated format was introduced by Citation Bot on 27 November 2016 and that used Chicago. That was stable for over three years until you unilaterally changed the style from Chicago to Vancouver on the pretext of "consistent citation formatting". The explosion of interest in remdesivir had indeed resulted in three references having been added using bare urls, but the earlier nine references were still in Chicago style, and not a single reference in the version you changed was in Vancouver style, but you still changed them all to Vancouver. Not that it matters, but most of the citations at that point were not by Meodipt.

It is not in the interests of the article to have you, Treybien2 and Whywhenwhohow switching style back-and-forth, so please find a consensus here, or respect CITEVAR.

I have no problem with you arguing that one style of citation formatting is better than another, but both styles can shorten the displayed list of authors with a single parameter, so neither offer any advantage on that score. This is a not a paper encyclopedia and we are not short of room, so the reason that some editors prefer to keep extra information in a citation is precisely to avoid forcing a reader to go elsewhere to find information that we have the capability of rendering for them here. If you want to see Chicago style deprecated, you know where to take the proposal, but until that happens, you will have to respect CITEVAR: "If the article you are editing is already using a particular citation style, you should follow it; if you believe it is inappropriate for the needs of the article, seek consensus for a change on the talk page." --RexxS (talk) 15:31, 18 July 2020 (UTC)

but most of the citations at that point were not by Meodip At the time of my edit, 6 of the 8 citations that had authors were contributed by Meodip. Furthermore, there was no consensus to change the style that Meodip established. Boghog (talk) 16:26, 18 July 2020 (UTC)

most of the citations were from Meodipt Not that it matters, but 6 out of 12 is not "most". Which style did Meodip establish? All hand-crafted with one in "first-name last-name" and two in "last-name initial" formats? That's a rather difficult style to adhere to. The first consistent, templated style was established by Citation bot and it was stable for three years. That should be consensus enough for anybody. --RexxS (talk) 18:00, 18 July 2020 (UTC)

6 out of 8 is most (note that only 8 of the 12 citations had authors). Which style did Meodip establish? 3 out of the 4 initial citations that Meodip added were in Vancouver style including 3 of 3 journal cites. The only exception was a web cite that undoubtedly was copy and pasted from that web site. Meodip subsequently added several additional references also in Vancouver style, so clearly that is his preferred citation style. The addition of these additional refs demonstrates style imposed by Citation bot was not stable. Citation bot does respect and leave alone Vancouver style formatting, but not if the authors are stripped out by an editor before running the bot. Lack of discussion does not imply consensus. Boghog (talk) 18:51, 18 July 2020 (UTC)

Citations without authors are still citations, and 6 out of 12 is still not "most". On 27 November 2016, Citation bot quite clearly made the citation style Chicago, because that's what it did in 2016. The style remained until in 2018, Meodipt added a citation in no recognisable format, mixing raw text with {{cite journal}}, which was later turned into the same consistent Chicago style by Citation bot. In August 2019, Jarrod Baniqued added another cite in Chicago format. In January 2020, Meodipt added yet another reference in a mixture of raw text and templates. I'm sorry but I simply reject your assertion that Meodipt displayed any preference between Chicago and Vancouver styles, and the other contributors uniformly used Chicago for three years, which resulted in an article having had no Vancouver style references for those three years being converted into your personal preference without discussion, You converted 0 out of 13 into 13 out of 13, so that wasn't just "most" in Chicago style, it was all of them. --RexxS (talk) 00:18, 19 July 2020 (UTC)

This whole discussion is about author format. Obviously one cannot conclude anything about author format preference from citations that do not contain authors. 6 of of the 8 citations that included authors is a majority. Stop inappropriately inflating the denominator. Also citation bot did not standardize the citations. In fact, just the opposite. Before the first Citation bot edit, 3 of the 4 citations were in Vancouver style. Citation bot was not able to add authors to one of the citations whose authors were striped and did nothing to the fourth citation that was not in Chicago style. After Citation bots, two citation followed Chicago style, a third was missing authors, and a fourth followed a non-Chicago style. Finally 7 of the 8 citations that Meodipt added that contained authors were in Vancouver style. So that is clearly his preferred style. Vancouver style is not only my preference, but also the preference of the first major contributor. Hence my edit was completely consistent with WP:CITEVAR. Boghog (talk) 06:16, 19 July 2020 (UTC)

both styles can shorten the displayed list of authors with a single parameter In theory, a multi author list can be placed in a single |authors= parameter but this usage has been frowned upon because it does not produced clean meta data. For this reason, a lot of bot work has been done to move multi-author lists to either first/last or vauthors parameters. If someone moves Chicago style author names to a single author parameter, sooner or later, it will be undone by a bot or an editor. Storage of multi author lists in a single parameter is exactly the problem that |vauthors= was created to solve. The reason that |vauthors= can produced clean meta data is that it enforces a consistent author format with error checking that is easy for templates to parse. Boghog (talk) 08:00, 19 July 2020 (UTC)

This whole discussion is about edit-warring between two equally valid citation formats. You were the one who claimed but most of the citations at that point were not by Meodip, which turned out to be untrue. it is also untrue that Meodipt demonstrated any consistent style in the citations they added. It is true that the article was stable using Chicago style for three years, and it's also true that lack of discussion does indeed imply consensus. See WP:Silence and consensus.

both styles can shorten the displayed list of authors with a single parameter it's seems you're unaware of |display-authors=N, which you'll find limits the display to N names in Chicago style. --RexxS (talk) 15:49, 19 July 2020 (UTC)

We are going around in circles because you are using an unreasonable standard for what is considered consistent and are drawing conclusions on what constitutes a predominate author format from citations that don't even include authors. but most of the citations at that point were not by Meodip That in fact was originally your quote, not mine, to which you now apparently disagree with ;-) Just to be clear, it is true that most of the citations at that point that included authors were from Meodip. You also seem to be confused between |display-authors=N (that limits the number of displayed authors and leaves the author format unchanged) and |name-list-format= for which "vanc" is currently the only allowed value. |name-list-format=vanc will change Chicago style authors to Vancouver. We could do what you suggest if "chicago" were an allowed value, but currently it is not. I quite frequently insert |display-authors=6 (for example, in this edit) as the standard Vancouver style recommends that only the first six authors are displayed. Finally, the citation format was stable for more than 5 months when far more edits were made to this article compare to the previous three years. Boghog (talk) 18:40, 19 July 2020 (UTC)

We are going off at tangents in fact. But that's because you insist that half of the citations represent a majority when it suits your argument, but that it's okay to change all of the citations to a style not present in the article at that time. You wish to justify your wholesale conversion of the three-year stable Chicago style citations to your preferred version without discussion. You can't and you know that. The first stable and consistent citation style was not established by Meodip but by Citation bot, and that style was Chicago. CITEVAR refers to MOS:RETAIN and that is absolutely clear about not switching styles just to satisfy an editors personal preferences.

If you want to open a discussion here to find a consensus for the citation style, I'm more than happy to see it happen, but my objection remains to your assumption that you can switch styles without discussion. --RexxS (talk) 22:19, 19 July 2020 (UTC)

The facts are relevant and clear. 3/4 and not half (citations that do not have authors should not be included in the calculation). It is also clear that Meodip had a preferred citation style and the style was more consistent before Citation bots first edit than after. WP:CITEVAR states defer to the style of the first major contributor. Boghog (talk) 04:19, 20 July 2020 (UTC)

So it is OK for someone else to make a change in citation format without discussion and not OK for me to restore the originally established format when I have clear WP:CITEVAR justification? That makes no sense. Boghog (talk) 12:56, 20 July 2020 (UTC)

The facts are that (1) most of the citations were not made by Meodipt; (2) Meodipt showed no consistent style in the citations they added; (3) CITEVAR states:

As with spelling differences, it is normal practice to defer to the style used by the first major contributor or adopted by the consensus of editors already working on the page, unless a change in consensus has been achieved.

Note the link to WP:ENGVAR which is clear that "the style of the first major contributor" means "the variety found in the first post-stub revision that introduced an identifiable variety." The first identifiable variety was introduced by Citation bot and it was Chicago; before that were only hand-crafted, untemplated varieties. The consensus existed for over three years that the style to be used was Chicago. By either means, it's clear that you switched a stable Chicago style to Vancouver style, contrary to WP:CITEVAR.

It is not okay for anybody to change the entire citation format without discussion, and that applies to you and anybody else. That is why I opened this talk page thread and stated:

• I hope we can settle on a style, either the stable style ("Chicago") per CITEVAR, or a different style ("Vancouver") if consensus can be found for the change per CITEVAR.

All I'm hearing from you is an attempt to justify your switch from a version that had been stable for three years to your preferred version, which is a complete waste of time. The only outcome I'm interested in here is establishing a consensus for one style or the other through discussion of one style relative to the other, rather than a fait accompli attempting to decide the matter. It's time you asked for more opinions either through a formal or an informal RfC. Let me know if you need any help in setting one up. --RexxS (talk) 15:44, 20 July 2020 (UTC)

A RfC at this time is premature as we must first agree on what the facts are. Furthermore, the only way we are going to get anywhere is to discuss one issue at a time. The first identifiable variety was introduced by Citation bot That is flat out wrong. What this series of two edits did was replace three Vancouver style citations with two Chicago style style citations and remove one Vancouver style citation. In another words, there was more of a recognizable citation sytle before Citation bot edit than after. Correct? Boghog (talk) 16:46, 20 July 2020 (UTC)

We don't have to agree on anything, but if you don't want to open a RfC, that's fine. The first identifiable style was Chicago, used in November 2016 by both Anypodetos and Citation bot. Prior to that, the styles in place were a hand-crafted mish-mash of different styles. After that, and for the next three years, the stable style was Chicago. By November 2019, the number of citations had grown to ten, all of which were templated, although two of those also had additional hand-written text. Of those ten, seven had authors, all of which were in Chicago style. The only recognisable format up until then was Chicago and it had been stable for three years. Do you disagree with that? --RexxS (talk) 17:15, 20 July 2020 (UTC)

One topic at a time, I will get to the other topics later. The first identifiable style was Chicago – false. As I have stated several times above, the first identifiable citation style was Vancouver. Three of three of the original journal citations used a consistent rendering style, and that is Vancouver. The only outlier was a single web cite, based on Meodipt's subsequent edits in this article and numerous other contributions, it is clear that Vancouver is their preferred author format. Although, not my preference, non-templated citations are a valid style. After the first citation bot edit, only two of the four citations were in Chicago format. Hence there was less consistency after the first Citation bot edit compared to before. Correct? Boghog (talk) 18:10, 20 July 2020 (UTC)

The first identifiable style was Chicago, and I've told you stated that enough times. Before that there was no discernible style. I've made it quite clear to you that Meodipt did not use a consistent style and hand-crafted their citations. Meodipt did not establish the stable, consensus style. That was done starting with Anypodetos and Citation bot who were the first to introduce citation templates consistently. The style of those templates was Chicago and remained stable for over three years. In that time, none of Meodipt's succeeding edits ever added a citation template using Vancouver style. You were the first to do that. --RexxS (talk) 19:46, 20 July 2020 (UTC)

and I've told you that enough times. That is an extraordinarily arrogant statement. I am trying to have a discussion. I am not sure what you are trying to do. Stop it. Boghog (talk) 20:23, 20 July 2020 (UTC)

No worse that your arrogant "As I have stated several times above". You're not trying to have a discussion: you're simply repeating your own view multiple times, despite my refutations each time. I've asked you to bring in other opinions and to decide the issue with an RfC. You've refused all of that, and have simply persisted in restating your view time after time. I heard you the first time and disagreed. Now what else have you got to offer? --RexxS (talk) 21:29, 20 July 2020 (UTC)

despite my refutations each time What refutations? I have stated that Meodipt did establish Vancouver as the original author format with evidence. You have provided zero evidence that he did not other than stating that they introduced a mish-mash of different styles which is not true. To repeat, 3 of the 3 journal citations were completely consistent. The only outlier was a web citation. Furthermore you have not acknowledged that the Citation bot's first edit reduced consistency, not increased it. Boghog (talk) 21:54, 20 July 2020 (UTC)

As I have stated several times above vs. and I've told you that enough times The first is a statement of fact, the second is arrogant. Boghog (talk) 22:16, 20 July 2020 (UTC)

none of Meodipt's succeeding edits ever added a citation template using Vancouver style So what. Non templated citations are a valid citation style. Boghog (talk) 22:55, 20 July 2020 (UTC)

Your statement that "Meodipt did establish Vancouver" is untrue. The evidence is clear that they did not introduce a consistent style for anyone to follow. Additionally, you've failed to understand that CITEVAR requires editors to defer to the first consistent style established, not to an editor. The 4 citations added by Meodipt were not in any consistent style. Citation bot's first edit added to the templated style introduced by Anypodetos, which was the first consistent style in use (and deployed by two different accounts). You've ignored all of those facts, as well as failed to grasp the fact that while non-templated citations are an acceptable style, they do not provide the consistency of templated citations, which is why the latter are preferred. In this case, the non-templated citations did not provide a consistent format, which only emerged after the citation templates were used, and lasted for over three years until you unilaterally changed it to your preferred format. That is part of the campaign you've been engaged in for some time now, and it's obvious you have no interest in CITEVAR, just in trying to find pretexts to justify your crusade. If the best argument you've got left is to call me names, then it's time you gave it a rest and started considering the best interests of the article instead of your ego. --RexxS (talk) 17:52, 21 July 2020 (UTC)

• The 4 citations added by Meodipt were not in any consistent style. False. Three of three journal citations followed Vancouver. The only exception was a single web citation. Their subsequent addition of journal citations were all in Vancouver style.
• Citation bot's first edit added to the templated style introduced by Anypodetos, which was the first consistent style in use. False, 3 of 4 total citations and 3 of 3 journal citations following Vancouver is reasonably consistent. In fact the style was more consistent before Citation bots edit (3 of 4 followed Vancouver style) compared to after Citation bots edit (2 of 4 followed Chicago style).
• In this case, the non-templated citations did not provide a consistent format False. Three of the three journal citation were consistent. Consistency is easier with templates, but it is certainly possible as was done it this case to have consistently formatted journal citations without a template.
• failed to grasp the fact that while non-templated citations are an acceptable style, they do not provide the consistency of templated For the very reason that you have stated, I prefer templated citations. But to imply that only templated citations can be consistently formatted is not accurate.
• it's obvious you have no interest in CITEVAR Quite to the contrary. I am deferring to the style used by Meodipt, the first major contributor. Hence my edit was completely consistent with CITEVAR.
• Boghog (talk) 18:41, 21 July 2020 (UTC)

Wow such a heated discussion! Chill people. I guess I do prefer the Vancouver style though am probably a bit sloppy about it at times. Really I'm not sure why its such a big deal so long as the relevant information is there? Meodipt (talk) 09:38, 23 July 2020 (UTC)

Thanks Meodipt for your prescient creation the article in the first place. I humbly suggest that we revert back to the originally established citation format. Boghog (talk) 18:03, 23 July 2020 (UTC)

Since there has been no further objections for the past four days, I will return the citation format to the Status quo ante bellum. Boghog (talk) 19:30, 25 July 2020 (UTC)

I certainly have to objection to either style: both have their advantages and disadvantages, but many of the editors who amended the style have been pinged to this discussion, and I think it's safe to take their silence as consent to your proposal to use Vancouver style. That should stop any prospect of further edit-warring over the citation style. --RexxS (talk) 19:54, 25 July 2020 (UTC)

ref is broken

the ref "Hopkins" does not lead to claimed article, but a search page. i suspect the end of the url is missing. Krisztián Pintér (talk) 13:22, 3 August 2020 (UTC)

Semi-protected edit request on 19 September 2020

I suggest some edits to the "Veterinary Uses" section. The current text is as follows:

GS-441524 was shown in 2019, to have promise for treating feline infectious peritonitis caused by a coronavirus. It has not been evaluated or approved by the US Food and Drug Administration (FDA) for the treatment of feline coronavirus or feline infectious peritonitis but has been available since 2019, through websites and social media as an unregulated black market substance as confirmed by the UC Davis School of Veterinary Medicine. Because GS-441524 is the main circulating metabolite of remdesivir and because GS-441524 has similar potency against SARS-Cov-2 in vitro, some researchers have argued for the direct administration of GS-441524 as a COVID19 treatment.

Suggested changes:

1. Copy edits for grammar and punctuation:
   • "GS-441524 was shown in 2019, to have promise …" -> "In 2019, GS-441524 was shown to have promise …"
   • "… peritonitis but has been available since 2019, through websites …" -> "… peritonitis, but has been available since 2019 through websites …"
2. Remove unnecessary attribution "as confirmed by the UC Davis School of Veterinary Medicine", the ref is enough.
3. Expand and clarify last sentence connecting GS-441524 to COVID-19. (This could probably be further improved, but this is my attempt at a reasonable first step. The main concerns are being faithful to the sources and giving the topic due weight without overstating it.)
   • "GS-441524 is the parent nucleoside of remdesivir and the main metabolite of remdesivir that circulates in the bloodstream. Based on veterinary research into GS-441524's efficacy, some scientists have argued that GS-441524 may be superior to remdesivir as a potential COVID-19 treatment."
   • Additional reference: https://doi.org/10.1021/acsmedchemlett.0c00316

Final copy:

In 2019, GS-441524 was shown to have promise for treating feline infectious peritonitis caused by a coronavirus. It has not been evaluated or approved by the US Food and Drug Administration (FDA) for the treatment of feline coronavirus or feline infectious peritonitis, but has been available since 2019 through websites and social media as an unregulated black market substance.

GS-441524 is the parent nucleoside of remdesivir and the main metabolite of remdesivir that circulates in the bloodstream. Based on veterinary research into GS-441524's efficacy, some scientists have argued that GS-441524 may be superior to remdesivir as a potential COVID-19 treatment.

143.244.37.236 (talk) 21:22, 19 September 2020 (UTC)

This is in the news again (10-3)

Heads up ya'll, Trump is taking this shit. We're gonna be hearing about it nonstop for right about the next month.

I'm not adding that tidbit to the article. 216.106.94.95 (talk) 04:22, 3 October 2020 (UTC)

To follow up on that: Expect brigades, consider making this protected. 216.106.94.95 (talk) 04:23, 3 October 2020 (UTC)

Two "Research" Sections

There are two sections in this article both named "Research" DavidConrad (talk) 20:24, 4 October 2020 (UTC)

The final report on the ACTT was just published in the NEJM

I don't have the time to add the full citation to the article right now, but the article is here: https://www.nejm.org/doi/full/10.1056/NEJMoa2007764 --Coolcaesar (talk) 16:51, 9 October 2020 (UTC)

Semi-protected edit request on 14 October 2020

Remdesivir was also shown to inhibit nucleotide incorporation when present in the template strand. MatthiasGotte (talk) 18:35, 14 October 2020 (UTC)

 Not done. It's not clear what changes you want to make. –Deacon Vorbis (carbon • videos) 19:30, 14 October 2020 (UTC)

References

Development

The wiki talkes about the development of Remdesivir as if it was exclusively developed by Gilead, which seems to be how Gilead markets it.

However, it seems to be well documented and uncontroversial that Remdesivir was almost entirely developed outside Gilead, largely by public (or publicly funded) institutions e.g. https://www.statnews.com/2020/05/08/acknowledging-public-role-drug-development-lessons-remdesivir/ https://www.keionline.org/wp-content/uploads/KEI-Briefing-Note-2020_1GS-5734-Remdesivir.pdf

Is there anyone who would be happy to find more sources and edit the article accordingly? As is, it's serving to promote Gilead's marketing claims rather than an attempt at objectively reflecting the reality. — Preceding unsigned comment added by 176.61.109.232 (talk) 11:22, 16 October 2020 (UTC)

If you were actually following the extensive months-long online debate on this topic, you would know that HHS is refusing requests to exercise Bayh-Dole Act march-in rights because Gilead conducted all the early work on development of remdesivir. --Coolcaesar (talk) 15:59, 16 October 2020 (UTC)

Correction to diagram

The sequence of chemical steps shown with caption "Activation of remdesivir into its active triphosphate metabolite" includes the incorrect label "GS-41524 Nucleoside" , which should be "GS-441524 Nucleoside". The correct designation is already shown in the article text. 73.221.180.35 (talk) 19:13, 23 October 2020 (UTC)

 Fixed. Thanks for your sharp eyes. Boghog (talk) 21:34, 24 October 2020 (UTC)

Reply to edit request now in talk archives

 Courtesy link: Talk:Remdesivir/Archive 1 § Semi-protected edit request on 19 September 2020

There was an edit request on the talk page (now in the talk archives) asking for some changes to be made, and I'm replying to it here, so I don't change the archived version of the talk page: @143.244.37.236,

 Partly done: I've made the first two changes you wanted, but as the third change is about changing what the information in this article actually says about the drug, I've not changed that as I don't know enough about it to do so. I suggest that if you still want it changed, you make another edit request asking for it to happen. Seagull123 Φ 21:11, 28 October 2020 (UTC)

Results of Solidarity Trial show Remdesivir has no impact on mortality in covid-19 patients

From the Guardian: Boseley, Sarah (16 October 2020). "Remdesivir has very little effect on Covid-19 mortality, WHO finds". The Guardian. Retrieved 16 October 2020. Desertborn (talk) 12:20, 16 October 2020 (UTC)

There are several news stories covering criticism of the Solidarity trial's findings: the New York Times, NBC News, NPR, and Time. --Coolcaesar (talk) 19:14, 19 October 2020 (UTC)

It's also not been fully peer reviewed yet to my understanding, meaning it is subject to our requirements for preprint sources (namely that they be only used with a grain of salt and very very very rarely). I don't recommend including the study until it's peer reviewed and the coverage of it at that time, there is no deadline or rush. -bɜ:ʳkənhɪmez (User/say hi!) 19:18, 19 October 2020 (UTC)

Concur. Which means the current discussion of the Solidarity trial in the article should be deleted until the final peer reviewed article comes out. --Coolcaesar (talk) 20:03, 19 October 2020 (UTC)

I don't agree. The Solidarity Trial's interim report is not "just a preprint". It is an official communication from the World Health Organization (it is published on their website), and it concerns one of the largest randomized trials on COVID-19 treatment. It thus comes from a valid source according to Wikipedia standards, and it contains highly relevant informations. I recommend putting it back to acknowledge its existence, but with a mention that it has not yet be published in a scientific journal. Pablo Picossa (talk) 02:06, 23 October 2020 (UTC)

The World Health Organization themselves point out that the data have not yet been peer reviewed yet. Preprints are not peer reviewed - and there has already been some very valid criticism throughout the scientific world of the study itself. I find it very unlikely the study gets published without a qualification that the science in the study is... less than sound. There is no rush to get something "acknowledged" on Wikipedia - it is within our policies to wait until it is "settled science" before we report it. We do not report on "breaking news" here - and that is exactly what you're advocating we do here, for no policy based reason. -bɜ:ʳkənhɪmez (User/say hi!) 02:26, 23 October 2020 (UTC)

I think you missed the point. Let start by "The World Health Organization themselves point out that the data have not yet been peer reviewed yet". Could you please provide a link for that? Because the way you phrase it suggests the they distrust their own results... It is completely absurd to believe that the they would make a press release to announce shady results. I encourage you to read the press release if you havent't yet: https://www.who.int/news/item/15-10-2020-solidarity-therapeutics-trial-produces-conclusive-evidence-on-the-effectiveness-of-repurposed-drugs-for-covid-19-in-record-time . What they say is "The results of the trial are under review for publication in a medical journal and have been uploaded as preprint at medRxiv". It doesn't says they don't stand by the conclusions highlighted in their own press release ("Interim results from the Solidarity Therapeutics Trial, coordinated by the World Health Organization, indicate that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients"). There is no conditional there. I must admit, however, that I'm not a specialist of WHO. If you say they don't know what they are doing and it would be better to wait until three Ph.D. students peer review their work (I am sarcastic, but I know how academic science work), please send me some lectures about WHO's scientific illiteracy and I will educate myself. Next, your "we don't do breaking news report" objection... The press release is already a week old, and despite valid criticisms of the report as you said (a lot by Gilead Sciences...), they haven't retracted their report and it didn't turned into a scandale or complete debunk. So while its recent, we are no longer in the breaking news of the day here. Third, "we wait until it is "settled science" before we report it". Let's be honest, almost nothing related to COVID19 is "settled science" on that wiki page. Not even the conclusions from the NEJM paper (you should read its conflict of interest disclosure by the way). My point is that reliable science sources are not limited to peer reviewed journal articles (you know >50% are flawed in some fields, right?). And you must know that organizations like WHO are also considered as reliable sources on Wikipedia, it is even qualified as a "widely respected governmental and quasi-governmental health authorities" in your own citation policies: (https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)#Use_up-to-date_evidence). The plain truth is that we don't have a clear idea of the potency of remdesivir on COVID-19 right now, and I think the WHO's press release and interim report are both valid sources that help to accurately describe that reality.Pablo Picossa (talk) 05:40, 23 October 2020 (UTC)

Pablo Picossa, please feel free to read the quote from the link you yourself posted: preprint, interim and another part of that page: The results of the trial are under review for publication in a medical journal and have been uploaded as preprint at medRxiv available at this link. We don't care who the preprint comes from on Wikipedia - the CDC publishing a preprint is no different than the WHO publishing one, and neither of those is different from your independent academic researcher at a university publishing a preprint of their work. They're all preprints. There actually is a conditional by the way: appeared to - that's literally saying "it looks like it, but let's wait for this to be peer reviewed before we say for sure".

They haven't retracted their report because it's already qualified as a preprint - they've done everything right, you're just trying to read more into it than they actually said and you're trying to interpret it incorrectly. Neither a press release nor a preprint is a valid source for medical content - a WHO guideline or finalized, published report would be, but not a preprint nor a press release about that preprint. Please feel free to wait for others to comment here, but you seem to be ignoring the reality of the situation which is that this (and any information from it, no matter if it's in a press release or in a preprint or whatever) is not information that should be included at this time per WP:MEDRS. -bɜ:ʳkənhɪmez (User/say hi!) 13:05, 23 October 2020 (UTC)

OK, press releases from organizations such as WHO or CDC reporting preliminary results are not valid sources on Wikipedia… I get it. To respect that policy, should we also remove that press release from NIAID in April (ref #28)? And what about the comment from John David Norrie published in the Lancet (ref #32)? It is not a peer reviewed research article, is it a valid medical source? How does it weights compared to this coverage of the Solidarity Trial preliminary results published in Science and quoting Eric Topol? (https://www.sciencemag.org/news/2020/10/remdesivir-and-interferon-fall-flat-who-s-megastudy-covid-19-treatments). Would I be allowed to use that later reference as a valid source? I’m not trying to get the last word, I am just trying to find some coherence without doing politics. Thank you.Pablo Picossa (talk) 20:03, 23 October 2020 (UTC)

Pablo Picossa, you aren't wrong that both of those should be examined as well for their appropriateness as well. However, that does not mean that simply because those are inappropriate that we add more inappropriate. Coverage of a preprint is still coverage of a preprint. There is no rush to include this information before it is peer reviewed. -bɜ:ʳkənhɪmez (User/say hi!) 20:14, 23 October 2020 (UTC)

Hi Berchanhimez. You should definitely read that new report published in Science about the Remdesivir approval story. Especially this quote somehow related to our discussion above: "It does not matter that the data have not yet been peer reviewed, WHO scientists say, because FDA traditionally reviews all available data, including unpublished findings." Of course Wikipedia is not the FDA, but I thought it might help you reconsider your position in the future (I don't have time for editing or long arguing right now). I'll come say hi again when the trial results get published in a peer reviewed article. Cordially. Pablo Picossa (talk) 01:04, 30 October 2020 (UTC)

Pablo Picossa, sorry for the delay in response, I forgot to return to this page after having seen it when I couldn't reply in depth. I'll preface this by saying that the results of the Solidarity trial are certainly being utilized by myself and other clinicians in our practices - along with multiple other sources. I personally have quite a few qualms with the data in the trial which I hope the peer review process will bring to light - thus while I've read the results and include them in my consideration of "all available evidence" to make decisions personally, it brings up a good point as to why WP:MEDRS strongly discourages the use of pre-review (preprint) data in articles here. There is no deadline on Wikipedia - if the study gets peer reviewed and the conclusion that "there is no benefit" holds in its entirety without any qualification or clarification, then we certainly will include that. But until that time, it is not so urgent that we must go against WP:MEDRS to include it now - at least not without including the large amount of criticism of the study's methodology and analysis. We certainly cannot as of yet use the study results to say in Wikipedia's voice that it has no proven benefit or similar - again, MEDRS requires that statements from primary sources such as one study (which even though it's WHO sponsored it still is) are attributed appropriately. TLDR, waiting for it to be peer reviewed is the best path forward here. Regards -bɜ:ʳkənhɪmez (User/say hi!) 01:45, 1 November 2020 (UTC)

European Medicines Agency licence

I've just removed this recently added content:

• In November 2020, based on the updated WHO guideline on therapeutics for COVID-19, the European Medicines Agency announced that they will evaluate new data from the Solidarity trial to see if any changes are needed to the marketing authorization of remdesivir in the EU.<ref name="EMA 20201120">{{cite web | title=Update on remdesivir | website=[[European Medicines Agency]] (EMA) | date=20 November 2020 | url=https://www.ema.europa.eu/en/news/update-remdesivir-ema-will-evaluate-new-data-solidarity-trial | access-date=20 November 2020}}Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</ref>

There is a problem that the European Medicines Agency asserts its copyright, but then adds this rider on reproduction:

Information and documents made available on the Agency's webpages are public and may be reproduced and/or distributed, totally or in part, irrespective of the means and/or the formats used, for non-commercial and commercial purposes, provided that the Agency is always acknowledged as the source of the material. Such acknowledgement must be included in each copy of the material.

That falls a short of the CC-BY-SA 3.0 licence used on Wikipedia because it does not explicitly allow derivative works, nor does it address the issue of further re-use of the material. It's a pity that many organisations are not savvy enough to make use of standard Creative Commons licences, but I believe the EMA "licence" is nearest to CC-BY-ND, which is not compatible with Wikipedia – see WP:Compatible licence.

I suggest that the content of the source should be summarised and cited in the usual manner, as that would be sufficient to satisfy the EMU's requirements for citation (rather than reproduction). --RexxS (talk) 17:49, 21 November 2020 (UTC)

See Also

I think the "mechanism of action" section is too technical and could be better explained by comparing this to 3TC, Emtrabicne and AZT. Basically, this prodrug metabolizes into "fake cytidine" the way that AZT is "fake thymidne." Putting pictures of real cytidine and the Remdesivir-cytidne "fake cytidine" side-by side would illustrate what is meant by analog. When you build a strand of RNA or DNA and a "fake letter" gets in there, it falls apart ("chain termination") as they put it. Also, because the fraud behind the original AZT trials is pretty well known as is the widespread death in the early 90's from AZT poisoning, pharmaceutical marketing and branding distances itself from AZT, but it's really just the same principle, just on a different letter of the DNA alphabet. These drugs were marketed as "reverse transcriptase inhibitors" but this is really misleading, and the reason Gilead doesn't market it as an HIV drug is because 3TC and Emtrabicne are both less toxic, so they whipped up the virus-of-the-moment to apply the old failed AZT strategy and shoved it out to market under a conditional use authorization. These are chemotherapies developed in the National Cancer program and nowhere does the article even say it's chemotherapy. "Fake cytidine" is going to impact cell division anywhere in the body and the principle was if you interfered with cell division it would disproportionately impact the rapidly dividing tumor cells. — Preceding unsigned comment added by 38.126.71.24 (talk) 02:14, 31 October 2020 (UTC)

Comparisons like this are only useful if reliable, independent sources are making the comparisons. We cannot make our own comparisons without them being reported in reliable sources prior. -bɜ:ʳkənhɪmez (User/say hi!) 01:46, 1 November 2020 (UTC)

For reference relating to the mechanism of action in SARS-CoV-2, we can see a video model at https://twitter.com/CramerLab/status/1348935177028968449. The mechanism is that, after three nucleotides are added, steric clashes stall the SARS-CoV-2 polymerase. The article cited in that tweet is available at https://doi.org/10.1038/s41467-020-20542-0Cosmicaug (talk) 18:35, 12 January 2021 (UTC)

Semi-protected edit request on 22 November 2020

Would you move the pharmacology section up so that it's the first section after the introduction? The "Medical uses" isn't a normal section about medical use; it's just news about COVID, not a proper section that would mention aspects of medical use (e.g. ebolaviruses) that appear elsewhere in the article. As such, that section shouldn't appear near the top of the article. 108.39.223.134 (talk) 13:14, 22 November 2020 (UTC)

 Not done See MOS:MED#Drugs, treatments, and devices for suggestions about section ordering. In general readers will be more interested in usage/effectiveness than more specialised aspects of medical topics. Alexbrn (talk) 13:18, 22 November 2020 (UTC)

What are the medical uses? The 'Medical uses' section only brings into question whether it is effective for Coronavirus, and provides no information about the medical uses of Remdesivir 115.64.244.84 (talk) 11:39, 3 April 2021 (UTC)

Semi-protected edit request on 30 April 2021

On 12 May 2020, Gilead announced that it had granted non-exclusive voluntary licenses to five generic drug companies in India and Pakistan to manufacture remdesivir for distribution to 127 countries. The agreements were structured so that the licensees can set their own prices and will not have to pay royalties to Gilead until the WHO declares an end to the COVID‑19 emergency or another medicine or vaccine is approved for COVID‑19, whichever comes first. In May 2020, Bangladesh's drug manufacturer BEXIMCO became the first in the world to sell generic version of Gilead's remdesivir without the consent of the patent holder, thanks to WTO agreement. On 23 June 2020, India granted emergency marketing approval of generic remdesivir manufactured by two Gilead licensees, Cipla and Hetero Drugs. Nsdffd (talk) 14:08, 30 April 2021 (UTC)

 Not done. Please state what changes you would like to be made in a 'change X to Y' format. MBihun (talk) 17:51, 30 April 2021 (UTC)

References

Nature Communications article on mechanism

Open access article in Nature Communications, "Mechanism of SARS-CoV-2 polymerase stalling by remdesivir," https://www.nature.com/articles/s41467-020-20542-0 and discussion of the article on TWIV-819 https://www.microbe.tv/twiv/twiv-819/ "TWiV 819: How to stall a copy machine." This is a fairly technical discussion of the chemistry and mechanism of remdesivir, but the commentary on TWIV makes it easier for a non-chemist to understand. It's a good lesson in drug development. They also discuss why it's not effective in most circumstances. By the time symptoms appear, it's too late for an anti-viral. --Nbauman (talk) 07:34, 22 October 2021 (UTC)

New double-blind trial indicates Remdesivir very effective ...

... for the treatment of COVID-19 in non-hospitalized patients at high risk for disease progression. Nearly 10x the survival rate for patients receiving the treatment, than for those receiving a placebo..

Reuters https://www.reuters.com/lifestyle/science/protein-found-infected-cells-protects-virus-immune-system-remdesivir-helps-2021-09-27

Gilead Sciences https://www.gilead.com/news-and-press/press-room/press-releases/2021/9/veklury-remdesivir-significantly-reduced-risk-of-hospitalization-in-highrisk-patients-with-covid19

I didn't see anyting in either of those documents about 10x the survival. The primary endpoint was the composite of hospitalization or death by day 28. There were no deaths during that period. There was 1 death in the placebo group by day 59. --Nbauman (talk) 07:18, 22 October 2021 (UTC)

From the linked article:

Veklury demonstrated a statistically significant 87% reduction in risk for the composite primary endpoint of COVID-19 related hospitalization or all-cause death by Day 28 (0.7% [2/279]) compared with placebo (5.3% [15/283]) p=0.008.    

0.7% vs 5.3% is almost a 10x difference (7.5x) — Preceding unsigned comment added by SmigersSmigers (talk • contribs) 09:10, 27 October 2021 (UTC)

FDA current status?

Is it Emergency use or full approval? This source says it has full approval. Forich (talk) 19:47, 3 November 2021 (UTC)

References

Semi-protected edit request on 22 November 2021

Please change this line:

The most common side effect in people with COVID‑19 is nausea.

to

The most common side effect in COVID‑19 patients is nausea.

The meaning is identical, and it's more concise. 2600:1015:B024:265:D558:3173:11CF:4ED2 (talk) 11:59, 22 November 2021 (UTC)

 Done Tol (talk | contribs) @ 15:41, 22 November 2021 (UTC)

Covid-19 drugs in European Union

https://www.ema.europa.eu/en/medicines/human/EPAR/veklury

Veklury is an antiviral medicine used to treat coronavirus disease 2019 (COVID-19). It is used in adults and adolescents (from 12 years of age and weighing at least 40 kilograms) with pneumonia requiring supplemental oxygen (low- or high-flow oxygen or other non-invasive ventilation at the start of treatment). The medicine can also be used in adults who do not require supplemental oxygen and who are at increased risk of developing severe COVID-19.

Veklury contains the active substance remdesivir.

AUTHORISED. This medicine is authorised for use in the European Union.

See also:

https://en.wikipedia.org/wiki/Sotrovimab

https://www.ema.europa.eu/en/search/search?search_api_views_fulltext=Xevudy

https://www.ema.europa.eu/en/medicines/human/EPAR/xevudy

Xevudy is a medicine used for treating COVID-19 in adults and adolescents (from 12 years of age and weighing at least 40 kilograms) who do not require supplemental oxygen and who are at increased risk of the disease becoming severe.

Xevudy contains the active substance sotrovimab.

AUTHORISED. This medicine is authorised for use in the European Union.

--128.214.204.173 (talk) 17:45, 16 January 2022 (UTC)

Works very well for nonhospitalized people also, 87% risk reduction!

https://www.nejm.org/doi/full/10.1056/NEJMoa2116846

We conducted a randomized, double-blind, placebo-controlled trial involving nonhospitalized patients with Covid-19 who had symptom onset within the previous 7 days. Among nonhospitalized patients who were at high risk for covid-19 progression, a 3-day course of intravenous remdesivir resulted in an 87% lower risk of hospitalization or death than placebo. Patients were ineligible if they had received a SARS-CoV-2 vaccine. --91.159.188.74 (talk) 15:45, 22 February 2022 (UTC)

This is primary research, which should only be used selectively for discussion of drugs under research. In the encyclopedia, we wait until high-quality WP:MEDRS reviews summarize the status of efficacy and safety as judged by experts. I trimmed the preliminary research details with this edit. Zefr (talk) 16:47, 22 February 2022 (UTC)

W.H.O. States it has no benefits for hospitalized

The W.H.O. Recommends against hospitalized patients using remdesivir [ https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients] because “ there is currently no evidence that remdesivir improves survival and other outcomes” Mrdthree (talk) 10:02, 20 May 2022 (UTC)

Kidney failure, death

There are pharmacovigilance reports of kidney failure such as this one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907730/ and there are legal actions being pursued by various people, since it is becoming apparent that death had resulted from administration of remdesivir. Look at this thread, for example: https://twitter.com/JohnBeaudoinSr/status/1624968661642448897. Widows in CA are suing over remdesivir being administered to their husbands, who died shortly afterwards. Here: https://www.cbsnews.com/losangeles/news/widows-suing-inland-empire-hospitals-for-covid-19-treatments-involving-remdesivir/ Is there anything good about this highly profitable drug? Boscaswell talk 11:03, 10 March 2023 (UTC)