Remdesivir in pill form shows promise as a more accessible treatment for COVID-19

CHAPEL HILL, N.C. — Remdesivir is already an FDA-approved treatment for COVID-19, but a new study finds turning this drug into a more easily accessible pill may help treat patients faster.

Typically administered intravenously, researchers from the University of North Carolina at Chapel Hill are testing out remdesivir in pill form in mice and the results are promising. Estimates show that doctors give remdesivir intravenously to roughly half of all hospitalized COVID-19 patients.

Study authors describe various lab tests indicating that a modified version of remdesivir is just as effective as molnupiravir, a different oral antiviral, at reducing coronavirus disease incidence in mice. Moreover, this new version of a remdesivir pill can stop coronaviruses before they multiply and cause severe disease.

“Oral antiviral medications have the potential to shorten the duration of disease, potentially diminish transmission and prevent hospitalization if taken early enough,” says senior study author Timothy Sheahan, a virologist at UNC Gillings School of Global Public Health, in a university release.

A pill, of course, is easier to administer than intravenous injection. The research team is hopeful a pill version of remdesivir can reach and help more people outside of hospital settings.

How does the drug beat COVID-19?

Remdesivir blocks the “machinery” SARS-CoV-2 needs to copy itself and spread all over the body. More specifically, this new compound, called GS-621763, can quickly turn into remdesivir once inside the human body. The pill version of remdesivir appears most protective against SARS-CoV-2 (the virus causing COVID-19), but it can also help treat MERS (Middle East Respiratory Syndrome).

“We saw protective effects, like reduced lung damage, viral load in the lungs, and improved lung function in infected mice, when we administered the drug at 12 hours or even at 24 hours after infection in mice,” explains lead study author Alexandra Schäfer, assistant professor of epidemiology at the UNC Gillings School of Global Public Health.

In early 2020, during the initial days of the COVID-19 pandemic, it was actually UNC-Chapel Hill virologist Ralph Baric and Gilead Sciences Inc. that recognized remdesivir as a possible means of treating COVID-19. In the two years since then, doctors have been giving remdesivir to critical COVID-19 patients all over the country.

New pill could stop COVID in the first days of infection

Clinical studies focusing on remdesivir’s effectiveness against COVID-19 have been promising but inconclusive. However, researchers say the drug is surprisingly helpful when patients take it early on in their infection. For example, one study found administering remdesivir during the early course of a patient’s infection led to an astounding 87 percent lower risk of hospitalization or death after just three days of treatment.

Moving forward, the team says much more work is necessary to refine and ensure this pill version of remdesivir is fit for widespread use.

“Oral drugs that can be formulated as pills have potential to make a big impact on reducing the disease burden caused the COVID pandemic,” concludes David R. Martinez, a viral immunologist and postdoctoral researcher at UNC Gillings School of Global Public Health. “People can safely take a round of pills at home while in isolation, and reduce community spread.”

The findings appear in the journal Science Translational Medicine.