The Remdesivir Anthology Series

A Collection of my Remdesivir Newsletters & Citations

Because my newsletters tend to become a series of multiple posts I will start collecting them together into one post anthology-style post. Hopefully, this would make it much easier to share and find for newer subscribers and for anyone who wants to check the backlog.

So over the next few days I will go through and make Newsletters for my posts on Quercetin, Hydroxychloroquine, and the Nasal Passage.

Also, now that Substack allows previews of paid posts I’ll retroactively add in preview sections for those who may be interested.

When it comes to citations, just so that I don’t create separate posts that may be unnecessary for most, I will include citations into these Anthology posts if there is no room in the final newsletter of the series. I’ll also try to better cite in-text citations. I’m realizing my citations may make my writings a bit bland and redundant in nature so I will instead try to incorporate footnotes.

And lastly, any additional newsletters that belong under one of these Anthology series will be added to the appropriate post. That way, it should be easy to reference back and view all the posts together.

Part I: Introduction, Brief History, and Mechanism of Action

This is the first post in the series and sets up the rest of the newsletters down the line. A twitter post lead to a testament by a COVID nurse discussing the ineffectiveness of treatments and the dangers of Remdesivir, leading to the search for evidence of possible toxicity.

Remdesivir: COVID's Standard of Care that May be Causing more Harm than Good (REVIEW)

Part II: The Remdesivir Evidence Before the Pandemic

Remdesivir hasn’t been around for long, but there still exists some in vitro studies of its efficacy. Many of these promising preliminary results lead to its adoption as a possible therapeutic against Ebola. Unfortunately, both the sparse number of studies and questionable results from clinical trials brought Remdesivir’s effectiveness into question.

Remdesivir: COVID's Standard of Care that May be Causing more Harm than Good (REVIEW)

Part III-1: Remdesivir in the Age of COVID

We start to examine the studies of Remdesivir against SARS-COV2 specifically. Once again, in vitro studies showed very promising results. However, the first clinical studies showed inconsistent results, although many factors may attribute to differences in results.

Remdesivir: COVID's Standard of Care that May be Causing more Harm than Good (REVIEW)

Part III-2: Remdesivir in the Age of COVID (Examining the NIH Study)

This post focuses more on the NIH trial (ACCT-1). The interim results of this study was pivotal to Remdesivir’s EUA approval. If we examine the study closely, we will find that the benefits of Remdesivir are highly specific and does not work as a “one size fits all” treatment option.

Remdesivir: COVID's Standard of Care that May be Causing more Harm than Good (REVIEW)

Part IV: Examining the Toxicity & Concluding Remarks

Here we get to the meat of the concern: is Remdesivir actually toxic? The evidence is inconsistent, and although it may not be conclusive, we can at least predict which groups are likely to suffer adverse reactions. I also provide my last remarks on Remdesivir and summarize all of the accumulated evidence.

Remdesivir: COVID's Standard of Care that May be Causing more Harm than Good (REVIEW)

Part V: When you blame everything but the drug.

This is a Paid Subscriber post. Instead of engaging in the precautionary principle and attributing possible toxicity to a drug and all aspects of a drug, it appears that there’s a greater interest in blaming adverse reactions on everything but Remdesivir.

Remdesivir: COVID's Standard of Care that May be Causing more Harm than Good (REVIEW)

Citations:

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2. Slusarczyk, M., Serpi, M. & Pertusati, F. Phosphoramidates and phosphonamidates (ProTides) with antiviral activity. Antiviral chemistry & chemotherapy (2018). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5971382/.

3. Veklury® (remdesivir) mechanism of action. HCP Available at: https://www.vekluryhcp.com/about/about-moa.php.

4. Pardo, J., Shukla, A. M., Chamarthi, G. & Gupte, A. The journey of remdesivir: From ebola to covid-19. Drugs in context (2020). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7250494/.

5. Agostini, M. L. et al. Coronavirus susceptibility to the antiviral Remdesivir (GS-5734) is mediated by the viral polymerase and the proofreading exoribonuclease. mBio (2018). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5844999/.

6. Warren, T. K. et al. Therapeutic efficacy of the small molecule GS-5734 against ebola virus in Rhesus Monkeys. Nature (2016). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5551389/.

7. Mulangu, S. et al. A randomized, controlled trial of ebola virus disease therapeutics: Nejm. New England Journal of Medicine (2019). Available at: https://www.nejm.org/doi/10.1056/NEJMoa1910993?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed.

8. Wang, M. et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-ncov) in vitro. Cell research (2020). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7054408/.

9. Williamson, B. N. et al. Clinical benefit of remdesivir in rhesus macaques infected with SARS-COV-2. bioRxiv (2020). Available at: https://www.biorxiv.org/content/10.1101/2020.04.15.043166v2.

10. Veklury (Remdesivir) FACT SHEET FOR HEALTH CARE PROVIDERS EMERGENCY USE AUTHORIZATION (EUA) OF REMDESIVIR (GS-5734™ https://www.fda.gov/media/137566/download.

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18. Kalakonda, Aditya. “Physiology, Bilirubin.” StatPearls [Internet]., U.S. National Library of Medicine, 16 Sept. 2021, https://www.ncbi.nlm.nih.gov/books/NBK470290/.

19. “Creatinine Tests.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 25 Feb. 2021, https://www.mayoclinic.org/tests-procedures/creatinine-test/about/pac-20384646.

20. “Electrocardiogram (ECG or EKG).” Www.heart.org, https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/electrocardiogram-ecg-or-ekg.

21. van Laar, S. A. et al. Liver and kidney function in patients with covid-19 treated with Remdesivir. British journal of clinical pharmacology (2021). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8251044/.

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23. Zampino, R. et al. Liver injury in remdesivir-treated COVID-19 patients. Hepatology international (2020). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7386240/.

24. Montastruc, F., Thuriot, S. & Durrieu, G. Hepatic disorders with the use of Remdesivir for coronavirus 2019. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association (2020). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7381904/.

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27. Gérard, A. O. et al. Remdesivir and acute renal failure: A potential safety signal from disproportionality analysis of the Who Safety Database. American Society for Clinical Pharmacology and Therapeutics (ASCPT) (2021). Available at: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2145.

28. Chouchana, L. et al. Kidney disorders as serious adverse drug reactions of Remdesivir in coronavirus disease 2019: A retrospective case-noncase study. Kidney international (2021). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7907730/.

29. Ackley, T. W., McManus, D., Topal, J. E., Cicali, B. & Shah, S. A valid warning or clinical lore: An evaluation of safety outcomes of Remdesivir in patients with impaired renal function from a multicenter matched cohort. Antimicrobial agents and chemotherapy (2021). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7849020/.

30. Delanaye, P., Cavalier, E. & Pottel, H. Serum creatinine: Not so simple! Nephron (2017). Available at: https://www.karger.com/Article/FullText/469669.

31. Nabati, M. & Parsaee, H. Potential cardiotoxic effects of Remdesivir on cardiovascular system: A literature review. Cardiovascular toxicology (2021). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8511861/.

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33. Abdelmajid, A. et al. Remdesivir therapy causing bradycardia in COVID-19 patients: Two case reports. IDCases (2021). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8359645/.

34. Gubitosa, J. C. et al. Marked sinus bradycardia associated with Remdesivir in COVID-19: A case and literature review. JACC. Case reports (2020). Available at: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7598346/.