<p>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.</p>.<p>On Friday, a World Health Organization guidelines panel advised against using the antiviral remdesivir for hospitalised patients, saying there's no evidence it improves survival or avoids the need for breathing machines.</p>.<p>But in the US 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 hospitalised patients by five days on average, from 15 days to 10.</p>.<p>Within the US, 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.</p>.<p>The groups say there isn't enough evidence to recommend for or against them.</p>.<p><a href="https://www.deccanherald.com/coronavirus-live-news-covid-19-latest-updates.html" target="_blank"><strong>CORONAVIRUS SPECIAL COVERAGE ONLY ON DH</strong></a></p>.<p>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.</p>.<p>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.</p>.<p>“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.</p>.<p>“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.</p>.<p>“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.</p>.<p>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 US-led one that found it had other benefits.</p>.<p>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.</p>.<p>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 US and other developed countries. In poor or middle-income countries, much cheaper versions are sold by generic makers.</p>.<p>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 hospitalised patients with moderate to severe disease because of the cost savings from fewer days of care. However, it's worth only $70 for patients hospitalised with milder disease, the group concluded.</p>.<p>Price also may be driving lower demand. In October, US 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.</p>.<p>Between July and September, 500,000 treatment courses were made available to state and local health departments but only about 161,000 were bought.</p>.<p>In a separate development, the FDA on Thursday gave emergency authorisation 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 hospitalised patients in one study.</p>.<p><strong>Also read: <a href="https://www.deccanherald.com/science-and-environment/eli-lilly-arthritis-drug-gets-usfda-nod-for-emergency-use-with-remdesivir-to-treat-covid-19-917746.html" target="_blank">Eli Lilly arthritis drug gets USFDA nod for emergency use with remdesivir to treat Covid-19</a></strong></p>.<p>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. </p>
<p>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.</p>.<p>On Friday, a World Health Organization guidelines panel advised against using the antiviral remdesivir for hospitalised patients, saying there's no evidence it improves survival or avoids the need for breathing machines.</p>.<p>But in the US 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 hospitalised patients by five days on average, from 15 days to 10.</p>.<p>Within the US, 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.</p>.<p>The groups say there isn't enough evidence to recommend for or against them.</p>.<p><a href="https://www.deccanherald.com/coronavirus-live-news-covid-19-latest-updates.html" target="_blank"><strong>CORONAVIRUS SPECIAL COVERAGE ONLY ON DH</strong></a></p>.<p>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.</p>.<p>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.</p>.<p>“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.</p>.<p>“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.</p>.<p>“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.</p>.<p>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 US-led one that found it had other benefits.</p>.<p>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.</p>.<p>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 US and other developed countries. In poor or middle-income countries, much cheaper versions are sold by generic makers.</p>.<p>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 hospitalised patients with moderate to severe disease because of the cost savings from fewer days of care. However, it's worth only $70 for patients hospitalised with milder disease, the group concluded.</p>.<p>Price also may be driving lower demand. In October, US 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.</p>.<p>Between July and September, 500,000 treatment courses were made available to state and local health departments but only about 161,000 were bought.</p>.<p>In a separate development, the FDA on Thursday gave emergency authorisation 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 hospitalised patients in one study.</p>.<p><strong>Also read: <a href="https://www.deccanherald.com/science-and-environment/eli-lilly-arthritis-drug-gets-usfda-nod-for-emergency-use-with-remdesivir-to-treat-covid-19-917746.html" target="_blank">Eli Lilly arthritis drug gets USFDA nod for emergency use with remdesivir to treat Covid-19</a></strong></p>.<p>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. </p>