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Coronavirus Updates: Gilead Sciences Announces The Coronavirus Drug Trial Results

ARI SHAPIRO, HOST:

Some good news today about a drug used to treat people with COVID-19 - preliminary results from a study involving more than a thousand patients showed remdesivir helped people recover faster and possibly also reduced deaths. Dr. Anthony Fauci directs the National Institute of Allergy and Infectious Diseases, which funded the study. And he said, though the results are promising, remdesivir is not a silver bullet for treating COVID-19.

(SOUNDBITE OF ARCHIVED RECORDING)

ANTHONY FAUCI: But we think it's really opening the door to the fact that we now have the capability of treating. And I can guarantee you as more people, more companies, more investigators get involved, it's going to get better and better.

SHAPIRO: Here to talk to us about remdesivir and other possible treatments for the coronavirus are NPR science correspondents Nell Greenfieldboyce and Joe Palca.

Good to have you both here.

JOE PALCA, BYLINE: Glad to be here.

NELL GREENFIELDBOYCE, BYLINE: Hey there.

SHAPIRO: Joe, let's start with you. What did we learn today about remdesivir.

PALCA: Well, we learned the results of the first randomized placebo-controlled trials of remdesivir in the U.S. And that's important because randomized placebo-controlled trials are what scientists refer to as the gold standard. You take a drug, in this case, that you want to study. You compare it to an inert compound, a placebo. You give it to patients. They don't know what they're getting. The doctors don't know what they're giving them but - so it's all - no biases can creep in. And you - if you see a difference, you can credit it to the drug. So this is how Dr. Fauci described one of the key findings today at a White - earlier today at a White House event.

(SOUNDBITE OF ARCHIVED RECORDING)

FAUCI: The data shows that remdesivir has a clear-cut significant positive effect in diminishing the time to recovery. It was 11 days compared to 15 days.

SHAPIRO: You know, the difference between 11 days and 15 days isn't a lot.

PALCA: Well, as you said at the top, this is not a silver bullet. I mean, people aren't going to get up and dance out of the room when they take this drug. They're sick. But I spoke with Evelyn Ling. She's what they call a hospitalist with Stanford Health Care-ValleyCare. And she actually worked on the remdesivir study, but she also sees patients as a clinical doctor. And she says for patients undergoing all sorts of treatments and sometimes winding up on ventilators, those four days are a big deal.

EVELYN LING: Every day you're in ICU, that's a lot of stress on the body. That's a lot of recovery time needed. Though I think if you can shorten that, I think that's great for our patients.

SHAPIRO: Not all the news about remdesivir today was good. Joe, I understand there was also a trial in China that did not show such positive results.

PALCA: Right. It's interesting. It's really a trial - the same kind of trial - a randomized placebo-controlled trial where they compared remdesivir with placebo. It was stopped because they ran out of patients. I mean, I guess that's a good thing. The trial was conducted in Wuhan, and there weren't any sick people in Wuhan. All these studies were done in hospitals. These are sick patients. But that study, which had about 250 or so patients, did not see a difference either in the time it took for people to get better or in the number of deaths or how many - yeah, how many people died. So equivocal smaller study - interesting but they're not showing the exact same thing.

SHAPIRO: There's another drug that people were pinning their hopes on, President Trump included, called hydroxychloroquine. Nell, tell us what the latest is on that drug. Has it panned out?

GREENFIELDBOYCE: Right, so that's the anti-malarial drug that some people were hoping would be good based on kind of anecdotal reports and some small early studies that weren't very well controlled. And research on that drug is continuing, but it doesn't appear so far to be, you know, a miracle or anything. I mean, there was a study by doctors at the Department of Veterans Affairs hospitals that looked back at people who'd been treated with it, and they found no apparent benefit and even what looked like possibly increased deaths in the group that got the drug. And, you know, the Food and Drug Administration came out recently warning people not to use it outside of a hospital setting or a clinical trial because of the risk of heart rhythm problems, so, you know, President Trump has mostly stopped talking about it. But there are still studies going on, like, to see if it might work for preventing people at high risk from actually getting infected.

SHAPIRO: Are there other drugs being researched right now beyond the two that we've been talking about?

GREENFIELDBOYCE: Oh, yeah. There's a whole bunch - I mean, all kinds of stuff. I mean, for example, in New York, doctors are testing the effect of a heartburn medicine, and the World Health Organization has a multi-country trial going on to evaluate four different treatments.

PALCA: And, you know, Ari, there's another drug that I've kind of got interested in that works like remdesivir but may be easier to use than remdesivir.

SHAPIRO: That sounds promising. Tell us more about that.

PALCA: Well, so remdesivir is a drug. The way it works is it prevents the virus from making copies of itself, so it stops it from spreading through the body and, obviously, spreading through the body is the way it causes havoc. Both remdesivir and this other drug, which has the artistic name of EIDD-2801...

SHAPIRO: (Laughter) OK.

PALCA: ...Are antivirals, right? You can remember that, right?

SHAPIRO: Sure.

PALCA: But the nice thing about this second drug - which I won't say the name again - is that it can be taken orally, which means you could put a pill in your mouth, as opposed to remdesivir, which has to be given intravenously. And that's a big deal, you know, in terms of how you deliver the drug and how easy it is to get from one place to another. And I talked to the president of Ridgeback Biotherapeutics, which is the company that makes the drug. And she said they're already planning to scale up their manufacturing capabilities, and they've started a phase one safety trial, which is the first step in showing that a drug can be used safely. And then, hopefully, they'll be able to demonstrate efficacy, so I think it's possible we'll be hearing more about that.

SHAPIRO: Beyond these clinical drug trials, I wonder about just, like, hospital experience. I mean, Nell, doctors have been caring for patients with COVID-19 for months now. Have they learned valuable things about the best way to treat people in hospitals?

GREENFIELDBOYCE: Right. So I mean, beyond the clinical trials, doctors just use their experience, and they talk to each other. And they try different tools, whatever they have at their disposal. And so for one thing, they've been much more aggressively treating patients with blood thinners because there's been a realization that clotting problems - blood clotting problems might be a factor in some poor outcomes with this disease. They're learning better when people need to go on ventilators and when people maybe can, you know, stay off ventilators for a while. There's a lot of talk about putting patients on their sides or on their stomachs to, you know, help them breathe that way just by repositioning their bodies. And so, you know, all that kind of stuff is going on along with the sort of more formal clinical trials. You know, unfortunately, doctors in this country are seeing a lot of this disease. I mean, at this point, there's more than a million diagnosed cases and around 60,000 deaths in the United States. So, you know, doctors are seeing a lot of it, and they're doing everything they can with what's at their disposal.

SHAPIRO: So in our last minute, Joe, big picture...

PALCA: Can I just...

SHAPIRO: Yeah, please jump in.

PALCA: Yeah. No, I was going to say there's one other thing to think about here. And that's that these drugs, both the remdesivir and the other one that I mentioned, EIDD-2801 - they are best used when the viral load, that is the amount of virus in somebody, isn't all that high. And so the studies that have been carried out so far are for patients who are very sick. And so a lot of doctors I've talked to say these might even be more effective if they could be given earlier in the course of treatment.

SHAPIRO: That is NPR science correspondent Joe Palca and Nell Greenfieldboyce.

Thank you both.

GREENFIELDBOYCE: Thank you.

PALCA: You're welcome. Transcript provided by NPR, Copyright NPR.

Nell Greenfieldboyce is a NPR science correspondent.
Joe Palca is a science correspondent for NPR. Since joining NPR in 1992, Palca has covered a range of science topics — everything from biomedical research to astronomy. He is currently focused on the eponymous series, "Joe's Big Idea." Stories in the series explore the minds and motivations of scientists and inventors. Palca is also the founder of NPR Scicommers – A science communication collective.

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