While new vaccines are being approved to stop the spread of COVID-19, medicines are still needed to treat hospitalized patients. Remdesivir is amongst the first and only antiviral agents approved by the USFDA so far for COVID-19.
However, researchers at the University of Cincinnati have said that it is being used too indiscriminately when treating patients hospitalized with the virus. The FDA had granted full approval for treatment in October 2020. The WHO in November 2020 stated that “More research is needed, especially to provide higher certainty of the evidence for specific groups of patients.” Researchers have found that remdesivir permanently stops the activity of an enzyme called carboxylesterase‐2 (CES-2) through covalent modifications. The CES-2 enzyme is found in the intestine, kidney, and liver and is needed for the breakdown of many medications.
This enzyme normally breaks down and activates certain antivirals and inactivated other medicines such as anticoagulants. The researchers further state that when remdesivir is delivered through the IV route, it does not treat the virus unless the body has additional specific enzymes, which are not found in all patients. It can also cause other antiviral drugs, such as those used for HIV/AIDs and hepatitis C, to not work properly. The researchers opine that remdesivir should be used cautiously and in proper dosages. Care should be taken when it is used in combination with other medications.
Ref link: https://onlinelibrary.wiley.com/doi/full/10.1111/fcp.12643