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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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jueves, 3 de diciembre de 2020

Remdesivir and lenght of stay

PulmCrit (EMCrit)
PulmCrit - December 3, 2020 - By Josh Farkas
"With the publication of the SOLIDARITY trial, there is increasing consensus that remdesivir doesn’t affect mortality. However, there continues to be debate about whether remdesivir affects hospital length of stay. Let’s dig into the data here to try to reconcile differences between ACTT-1 and SOLIDARITY.
  • Did ACTT-1 actually show that remdesivir reduces the hospital length of stay? Three major limitations.
    • Limitation #1: “time to recovery” versu
    • Limitation #2: Wide confidence intervalss “length of stay”
    • Limitation #3: Double-blind RCT vs real-world length of stay
  • SOLIDARITY: Remdesivir actually prolonged hospital length of stay!
    • The SOLIDARITY trial shows that remdesivir actually increases the hospital length of stay slightly
Essentially, ACTT-1 demonstrated that remdesivir might work in a magical universe (where patients were discharged immediately when they met discharge criteria). SOLIDARY showed that in the messy reality of clinical medicine, remdesivir doesn’t actually help – and it may actually prolong hospitalization...

This is a complex topic, because it remains possible that remdesivir does cause a minimal clinical improvement (which is likely clinically insignificant). Current studies cannot refute with 100% certainty that remdesivir causes some non-zero benefit (that is statistically impossible, as it would require an infinite number of patients)."