Bad news from China. There was not a statistically significant benefit for patients with severe Covid 19 in the large Chinese controlled trial of Remdesivir for patients with severe Covid 19. The death rate was actually a tiny bit higher in the treated group.
As a long time Remdesivirenthusast, I feel I have to note this result here. Now I will go off and cry.
OK also be stubborn. One argument is that the treatment was given too late when autoimmunity not viral replication was the main problem. A counterargument is that the trial of treatemnt for patients with moderate Covid was suspended and one suspects not with promising data.
Another argument is that the better end of the 95% confidence interval of the estimate of the relative hazard of improvement (mostly needed less extreme oxygen therapy) is 1.75 which is high. Part of the dismay is due to the error of considering failure to reject evidence in facor of the null. Priors should be updated with the likelihood and roughly in the direction of the point estimate. Here, as usual, there is a problem with treating current regulations as the scientific method. This is not as bad as looking only at the most pleasing part of a 95% interval, as I just did. I couldn’t resist.
On the other hand note the (slightly statistically insignificantly) worse death rate for the treated group.
But all in all a horrible disappointment (there were warning signs including the premature end of the trial)
Gilead, of course, contests the Statnews interpretation. They note that due to trouble recruiting patients the power of the test was low (my point above). They note there was (statistically insignificant) evidence that it helped. Needless to sau, they are even more biased than I am.
update: Again someone who might be biasd pro remdesivir, but definitely interesting.
Frederick Hayden, an infectious disease expert at the University of Virginia School of Medicine who helped the Chinese doctors conduct the study, disputed the characterisation that the study had failed.
“That is not correct,” Hayden said in an interview, when asked whether the results showed remdesivir had flopped. “My interpretation of them is not consistent with that headline.”
Hayden said there was a mistake in the original manuscript and that it had since been revised. He said that the study was under review at a journal, which he would not identify. and that the authors were still waiting for page proofs. He declined further comment or elaborate until the study was published.
I want to believe that the mistake was saying that Remdesivir didn’t show ntiviral activity based in RT PCR