Remdesivir (Molecule of the Month for September 2020)
Remdesiviris a broad-spectrum antiviral medication developed by the biopharmaceutical company Gilead Sciences. It is administered via injection into a vein. During the 2020 COVID-19 pandemic, remdesivir was approved or authorized for emergency use to treat COVID‑19 in around 50 countries. Updated guidelines from the World Health Organization in November 2020 include a conditional recommendation AGAINST the use of remdesivir for the treatment of COVID-19. Previously it had been tested from 2016 for the treatment of Ebola virus disease.
In November 2020, the World Health Organization (WHO) updated its guideline on therapeutics for COVID-19 to include a conditional recommendation against the use of remdesivir, triggered by results from the WHO Solidarity trial. The European Medicines Agency announced that they will evaluate new data to see if a revision to the authorization of remdesivir is needed.
In the European Union, remdesivir is indicated for the treatment of coronavirus disease 2019 (COVID‑19) in adults and adolescents with pneumonia requiring supplemental oxygen.
On 20 March 2020, United States President Donald Trump announced that remdesivir was available for "compassionate use" for people with COVID‑19; FDA Commissioner Stephen Hahn confirmed the statement at the same press conference. It was later revealed that Gilead had been providing remdesivir in response to compassionate use requests since 25 January.
On 29 June 2020, Gilead announced that it had set the price of remdesivir at US$390 per vial for the governments of developed countries, including the United States, and US$520 for US private health insurance companies. The expected course of treatment is six vials over five days for a total cost of US$2,340.Being a repurposed drug, the minimum production cost for remdesivir is estimated actually at less that a $ per day of treatment.
Remdesivir is a prodrug that is intended to allow intracellular delivery of GS-441524 monophosphate and subsequent biotransformation into GS-441524 triphosphate, a ribonucleotide analogue inhibitor of viral RNA polymerase. As an adenosine nucleoside triphosphate analog GS-441524, the active metabolite of remdesivir interferes with the action of viral RNA-dependent RNA polymerase and evades proofreading by viral exoribonuclease (ExoN), causing a decrease in viral RNA production. In some viruses such as the respiratory syncytial virus it causes the RNA-dependent RNA polymerases to pause, but its predominant effect (as in Ebola) is to induce an irreversible chain termination.
Formal Chemical Name (IUPAC)
Update by Karl Harrison
(Molecule of the Month for September 2020 )
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