Pharmacodynamics of Remdesivir: How to Improve for COVID-19 Treatment

Abstract

Potential clinical benefit in SARS-CoV-2 with remdesivir have been noticed. Recently, FDA has granted the use of remdesivir for COVID-therapy. However, the efficacy of remdesivir alone or with combination of other antivirals, like chloroquine or hydroxychloroquine is still questionable, especially in terms of benefits vs. risk ratio. We here did a search for relevant pharmacological evidences with regards to the Pharmacokinetics (PK) and Pharmacodynamics (PD) of appropriate antiviral compounds against COVID-19 alone or in combination with other potential therapies. Drug–Drug Interactions (DDIs), if any in case of combo treatment have also been taken into consideration. We found promising in vitro evidence for using remdesivir, in combination with (hydroxy) chloroquine and/or favipiravir against SARS-CoV-2. However, clinical trial results are not that satisfactory as expected and limit the use in practice. Additionally, some other drug combination with remdesivir have been proposed in this article for future improvement in therapies.