sunny.png
Thursday September 23rd, 2021 7:13PM

Health experts clash over use of certain drugs for COVID-19

By The Associated Press
Related Articles
  Contact Editor

Health officials around the world are clashing over the use of certain drugs for COVID-19, leading to different treatment options for patients depending on where they live.

On Friday, a World Health Organization guidelines panel advised against using the antiviral remdesivir for hospitalized patients, saying there’s no evidence it improves survival or avoids the need for breathing machines.

But in the U.S. and many other countries, the drug has been the standard of care since a major, government-led study found other benefits — it shortened recovery time for hospitalized patients by five days on average, from 15 days to 10.

Within the U.S., a federal guidelines panel and some leading medical groups have not endorsed two other therapies the Food and Drug Administration authorized for emergency use -- Eli Lilly’s experimental antibody drug and convalescent plasma, the blood of COVID-19 survivors. The groups say there isn't enough evidence to recommend for or against them.

Doctors also remain uncertain about when and when not to use the only drugs known to improve survival for the sickest COVID-19 patients: dexamethasone or similar steroids.

And things got murkier with Thursday’s news that the anti-inflammatory drug tocilizumab may help. Like the key WHO study on remdesivir, the preliminary results on tocilizumab have not yet been published or fully reviewed by independent scientists, leaving doctors unclear about what to do.

“It’s a genuine quandary,” said the University of Pittsburgh’s Dr. Derek Angus, who is involved in a study testing many of these treatments. “We need to see the details.”

Dr. Rochelle Walensky, infectious disease chief at Massachusetts General Hospital, agreed.

“It’s really hard to practice medicine by press release,” she said on a podcast Thursday with a medical journal editor. Until the National Institutes of Health’s guidelines endorse a treatment, “I’m really reluctant ... to call that standard of care.”

Angus said there are legitimate questions about all of the drug studies.

“It’s not unusual for professional guidelines to disagree with each other, it’s just that it’s all under the microscope with COVID-19,” he said.

The rift over remdesivir, sold as Veklury, by Gilead Sciences Inc., is the most serious. The WHO guidelines stress that the drug does not save lives, based heavily on a WHO-sponsored study that was larger but much less rigorous than the U.S.-led one that found it had other benefits.

The drug is given through an IV for around five days, and its high cost and lack of “meaningful effect” on mortality make it a poor choice, the WHO panel concluded.

Gilead charges $3,120 for a typical treatment course for patients with private insurance and $2,340 for people covered by government health programs in the U.S. and other developed countries. In poor or middle-income countries, much cheaper versions are sold by generic makers.

This week, the Institute for Clinical and Economic Review, a nonprofit group that analyzes drug prices, said remdesivir should be priced around $2,470 for hospitalized patients with moderate to severe disease because of the cost savings from fewer days of care. However, it’s worth only $70 for patients hospitalized with milder disease, the group concluded.

Price also may be driving lower demand. In October, U.S. health officials said that hospitals had bought only about one-third of the doses of remdesivir that they were offered over the previous few months, when the drug was in short supply. Between July and September, 500,000 treatment courses were made available to state and local health departments but only about 161,000 were bought.

In a separate development, the FDA on Thursday gave emergency authorization to use of another anti-inflammatory drug, baricitinib, to be used with remdesivir. Adding baricitinib shaved an additional day off the average time to recovery for severely ill hospitalized patients in one study.

Lilly sells baricitinib now as Olumiant to treat rheumatoid arthritis, the less common form of arthritis that occurs when a mistaken or overreacting immune system attacks joints, causing inflammation. An overactive immune system also can lead to serious problems in coronavirus patients.

___

Marilynn Marchione can be followed on Twitter at http://twitter.com/MMarchioneAP

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

  • Associated Categories: U.S. News, Associated Press (AP), AP National News, AP Online National News, Top U.S. News short headlines, Top General short headlines, AP Health
© Copyright 2021 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
US government executes man convicted of killing Texas teen
The U.S. government has executed a man who kidnapped and raped a 16-year-old Texas girl before dousing her with gasoline and burying her alive
1:25AM ( 1 hour ago )
Criminal probe, legal fights await Trump after White House
President Donald Trump’s legal entanglements are likely to intensify when he leaves the White House and loses immunity from prosecution
1:01AM ( 2 hours ago )
NY probes Trump consulting payments that reduced his taxes
New York’s attorney general has sent a subpoena to the Trump Organization for records related to consulting fees paid to Ivanka Trump as part of an investigation into the president’s business dealings
12:45AM ( 2 hours ago )
U.S. News
Azerbaijani army enters territory ceded by Armenian forces
Azerbaijan’s Defense Ministry says units of the Azerbaijani army have entered the Aghdam region, a territory ceded by Armenian forces in a cease-fire agreement that ended six weeks of heavy fighting over the separatist region of Nagorno-Karabakh
2:29AM ( 39 minutes ago )
Week 12: Big Ten unbeatens, Bedlam and Lawrence returns
The Big Ten's four unbeaten teams square off Saturday in two games that could go a long way toward settling the division races
2:18AM ( 50 minutes ago )
The Latest: Hong Kong to close more schools to fight virus
Hong Kong has suspended in-person classes for lower primary school students after the city’s top health official said the coronavirus situation in the city was rapidly deteriorating
1:59AM ( 1 hour ago )
Associated Press (AP)
Ladies' night at Latin Grammys: Lafourcade, Rosalía win big
A year after Rosalía made history by becoming the first solo female performer in 13 years to win the top prize at the Latin Grammys, Natalia Lafourcade followed in her footsteps with a big win at the 2020 show
12:51AM ( 2 hours ago )
Trump, allies make frantic steps to overturn Biden victory
President Donald Trump and his allies are taking increasingly frantic steps to subvert the results of the 2020 election, including summoning state legislators to the White House as part of a longshot bid to overturn Joe Biden’s victory
12:48AM ( 2 hours ago )
Wilson throws 2 TDs, Seahawks hold off Cardinals 28-21
Russell Wilson rebounded from his worst performance of the season to throw for two touchdowns, and the Seattle Seahawks moved back on top of the NFC West with a 28-21 win over the Arizona Cardinals
12:43AM ( 2 hours ago )
AP National News
Supreme Court clears way for federal execution in Texas case
The U.S. Supreme Court is clearing the path for the federal government to carry out the execution of a man convicted of kidnapping and raping a 16-year-old Texas girl, bludgeoning her with a shovel and burying her alive
11:27PM ( 3 hours ago )
California imposes curfew to curb skyrocketing COVID cases
California Gov. Gavin Newsom is imposing an overnight curfew as the most populous state tries to head off a surge in coronavirus cases
9:42PM ( 5 hours ago )
Federal judge blocks new criminal disqualifiers to asylum
A judge has blocked a Trump administration rule that would have put up new roadblocks for asylum-seekers convicted of a variety of crimes
9:39PM ( 5 hours ago )
Top U.S. News short headlines
Mexico becomes 4th country to hit 100,000 COVID-19 deaths
Mexico has passed the 100,000 mark in COVID-19 deaths, becoming only the fourth country _ behind the United States, Brazil and India _ to do so
9:24PM ( 5 hours ago )
US adult smoking rate looks unchanged, vaping rate higher
The U.S. decline in cigarette smoking could be stalling while the adult vaping rate appears to be rising
3:19PM ( 11 hours ago )
WHO chief denies Ethiopia's claim of backing Tigray region
The World Health Organization's Ethiopian director-general is denying the allegation of his own country that he has been lobbying neighboring nations to provide arms and other support to the defiant Tigray region while it clashes with Ethiopia's government
2:19PM ( 12 hours ago )
AP Health
US government executes man convicted of killing Texas teen
The U.S. government has executed a man who kidnapped and raped a 16-year-old Texas girl before dousing her with gasoline and burying her alive
1:25AM ( 1 hour ago )
Criminal probe, legal fights await Trump after White House
President Donald Trump’s legal entanglements are likely to intensify when he leaves the White House and loses immunity from prosecution
1:01AM ( 2 hours ago )
NY probes Trump consulting payments that reduced his taxes
New York’s attorney general has sent a subpoena to the Trump Organization for records related to consulting fees paid to Ivanka Trump as part of an investigation into the president’s business dealings
12:45AM ( 2 hours ago )
Supreme Court clears way for federal execution in Texas case
The U.S. Supreme Court is clearing the path for the federal government to carry out the execution of a man convicted of kidnapping and raping a 16-year-old Texas girl, bludgeoning her with a shovel and burying her alive
11:27PM ( 3 hours ago )
Supreme Court clears path for 8th federal execution
The U.S. Supreme Court is clearing the path for the federal government to carry out the execution of a man convicted of kidnapping and raping a 16-year-old Texas girl, bludgeoning her with a shovel and burying her alive
11:02PM ( 4 hours ago )