After securing an FDA go-ahead, Gilead Sciences has started testing of an inhaled formulation of its COVID-19 drug “remdesivir” in 60 healthy volunteers in the US. It is expected that this inhaled formulation should reach the outpatient setting where patients have less severe disease and with early treatment, hospitalization could be avoided. In the large-scale ACTT-1 study conducted by the National Institutes of Health, intravenous remdesivir already showed it could cut recovery time by four days, or by about 31%, among hospitalized patients. But its benefits appear less significant for patients with mild or moderate disease. Based on current scientific understanding, the upper respiratory tract is the most prevalent site of SARS-CoV-2 infection early in disease says Gilead’s chief medical officer, Merdad Parsey in a statement. There’s also concern regarding patient safety. In the ACTT-1 trial, some patients who got intravenous remdesivir experienced side effects such as anemia, acute kidney injury, and elevated liver enzymes—an indicator of liver damage—though none of them seemed to be much more frequent than the rates seen in the placebo group. But Gilead hopes that the inhaled formulation could reduce the side effects.
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