Association of Remdesivir Treatment With Mortality Among Hospitalized Adults With COVID-19 in the United States.

Autor:	Chokkalingam AP; Real World Evidence, Gilead Sciences Inc, Foster City, California.; Division of Epidemiology, School of Public Health, University of California, Berkeley., Hayden J; Aetion Inc, New York, New York., Goldman JD; Swedish Center for Research and Innovation, Swedish Medical Center, Providence St Joseph Health, Seattle, Washington.; Division of Allergy and Infectious Diseases, University of Washington, Seattle., Li H; Real World Evidence, Gilead Sciences Inc, Foster City, California., Asubonteng J; Real World Evidence, Gilead Sciences Inc, Foster City, California., Mozaffari E; Medical Affairs, Gilead Sciences Inc, Foster City, California., Bush C; Aetion Inc, New York, New York., Wang JR; Aetion Inc, New York, New York., Kong A; Aetion Inc, New York, New York., Osinusi AO; Clinical Development, Gilead Sciences Inc, Foster City, California., Gottlieb RL; Baylor University Medical Center, Dallas, Texas.; Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas.; Baylor Scott & White The Heart Hospital, Plano, Texas.; Baylor Scott & White Research Institute, Dallas, Texas.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2022 Dec 01; Vol. 5 (12), pp. e2244505. Date of Electronic Publication: 2022 Dec 01.
DOI:	10.1001/jamanetworkopen.2022.44505
Abstrakt:	Importance: SARS-CoV-2, which causes COVID-19, poses considerable morbidity and mortality risks. Studies using data collected during routine clinical practice can supplement randomized clinical trials to provide needed evidence, especially during a global pandemic, and can yield markedly larger sample sizes to assess outcomes for important patient subgroups. Objective: To evaluate the association of remdesivir treatment with inpatient mortality among patients with COVID-19 outside of the clinical trial setting. Design, Setting, and Participants: A retrospective cohort study in US hospitals using health insurance claims data linked to hospital chargemaster data from December 1, 2018, to May 3, 2021, was conducted among 24 856 adults hospitalized between May 1, 2020, and May 3, 2021, with newly diagnosed COVID-19 who received remdesivir and 24 856 propensity score-matched control patients. Exposure: Remdesivir treatment. Main Outcomes and Measures: All-cause inpatient mortality within 28 days of the start of remdesivir treatment for the remdesivir-exposed group or the matched index date for the control group. Results: A total of 24 856 remdesivir-exposed patients (12 596 men [50.7%]; mean [SD] age, 66.8 [15.4] years) and 24 856 propensity score-matched control patients (12 621 men [50.8%]; mean [SD] age, 66.8 [15.4] years) were included in the study. Median follow-up was 6 days (IQR, 4-11 days) in the remdesivir group and 5 days (IQR, 2-10 days) in the control group. There were 3557 mortality events (14.3%) in the remdesivir group and 3775 mortality events (15.2%) in the control group. The 28-day mortality rate was 0.5 per person-month in the remdesivir group and 0.6 per person-month in the control group. Remdesivir treatment was associated with a statistically significant 17% reduction in inpatient mortality among patients hospitalized with COVID-19 compared with propensity score-matched control patients (hazard ratio, 0.83 [95% CI, 0.79-0.87]). Conclusions and Relevance: In this retrospective cohort study using health insurance claims and hospital chargemaster data, remdesivir treatment was associated with a significantly reduced inpatient mortality overall among patients hospitalized with COVID-19. Results of this analysis using data collected during routine clinical practice and state-of-the-art methods complement results from randomized clinical trials. Future areas of research include assessing the association of remdesivir treatment with inpatient mortality during the circulation of different variants and relative to time from symptom onset.
Databáze:	MEDLINE
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