Hydroxychloroquine vs. Remdesivir

Hydroxychloroquine vs. Remdesivir The Verdict?

This is an interesting topic since it has been banned on social media from being posted. Hydroxychloroquine is a cheaper drug, can be obtained quite easily, and seems “safe” because it has been widely used for many years in the prevention of malaria.

Stephen Hahn, the commissioner of the Food and Drug Administration (FDA) on hydroxychloroquine. “A doctor and a patient need to assess the data that’s out there, FDA does not regulate the practice of medicine, and that in the privacy of the doctor-patient relationship is where that decision should be made.”

The price difference between Hydroxychloroquine vs. Remdesivir

The cost for hydroxychloroquine oral tablet 200 mg is around $37 for a supply of 100 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

Gilead Sciences set the price for remdesivir, its antiviral drug that can shorten hospitalization stays for individuals ill with coronavirus disease 2019 (COVID-19) from SARS-CoV-2 infection, at $520 a vial, or $3120 per patient for a typical treatment course, for those with private insurance.

The price of those not covered by private insurance will be $390 per vial. A treatment course is 6 vials. The FDA approved the drug for emergency use in some patients and the company has applied for full approval.

The real story of Remdesivir

New information by Public Citizen estimates that taxpayers have contributed at least $70.5 million to develop the drug, nearly double a previous public estimate of $37.5 million. Initially tested by Gilead as a hepatitis C treatment, Remdesivir was refined, developed, and evaluated by federal scientists for Ebola and coronaviruses.

The research outlined below demonstrate how the U.S. Army, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH)/National Institute Allergies and Infectious Diseases (NIAID) either conducted or funded much of the preclinical and clinical development of Remdesivir (formerly referred to as GS-5734)

https://www.keionline.org/wp-content/uploads/KEI-Briefing-Note-2020_1GS-5734-Remdesivir.pdf

https://www.nejm.org/doi/full/10.1056/NEJMoa2021436

Research

Remdesivir

https://www.biorxiv.org/content/10.1101/2020.04.15.043166v2.full.pdf

Small sample but showed promising results for macaques monkeys. 2 samples of 6 monkeys in each. One was given IV Remdesivir the other one has a placebo. The study showed that Remdesivir monkey had 

  • Less respiratory disease
  • Reduced virus replication in the lower, but not upper respiratory tract
  • Decreased viral loads in the lungs 
  • Reduced pneumonia

https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

A double-blind study examined the effectiveness of Remdesivir in 538 patients vs 521 in the placebo. The Remdesivir group had:

  • Quicker recovery time, 11 vs 15 days
  • Less mortality 7.1% vs 11.9 %

https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

53 patients were given Remdesivir and results showed promising favor for Remdesivir.

  • Clinical improvement was observed in 36 of 53 patients (68%)
    • Including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated
    • 25 patients (47%) were discharged
    • 7 patients (13%) died

Hydroxychloriquine

https://www.mediterranee-infection.com/wp-content/uploads/2020/04/MS.pdf

An observational study in a cohort study of 1061 pts with COVID – 19 treated with hydroxychloroquine and azithromycin. Mean age was about 44

  • Good clinical outcome and virological cure were obtained in 973 patients 
  • A poor clinical outcome was observed for 46 patients (4.3%) and 8 died (0.75%)
  • Five patients are still hospitalized 
  • 98.7% of patients cured so far

https://pgibertie.files.wordpress.com/2020/04/2020.04.15-journal-manuscript-final.pdf

412 started treatment with hydroxychloroquine and azithromycin and 224 refused

Medications. The mean age was 62.5. The patients were suspected to have COVID19 infection.

  • Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group
  • Showed that early use of hydroxychloroquine reduces hospitalization need.

https://www.sciencedirect.com/science/article/pii/S0924857920300996

Sample of 36 people where 20 were treated with hydroxychloroquine and 16 were the control. Smaller sample, unfortunately.

  • At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologically cured compared to 12.5% in the control group eventually reaching 100% clearance.

https://www.ijme.in/wp-content/uploads/2020/06/Covid-19-DANG-HCQ-and-RDV-JUNE-18-Final.pdf

  • Both HCQ and RDV were shown to inhibit the in-vitro growth of SARS-CoV-2. 
  • HCQ co-administered with azithromycin provides a virological cure and low mortality with no cardiac toxicity
  • RDV shortens time to recovery but without any significant mortality benefit

The Verdict

These results show that both drugs have a positive impact on fighting COVID-19. All 6 studies above demonstrate results that both drugs show clinical improvement and inhibit the in vitro growth of COVID-19.

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