Tocilizumab, Remdesivir, Favipiravir, and Dexamethasone Repurposed for COVID-19: a Comprehensive Clinical and Pharmacovigilant Reassessment

Abstract

In this manuscript, we discuss the expectations versus the real-world results of four repurposed COVID-19 drugs: tocilizumab, remdesivir, favipiravir, and dexamethasone from a clinical and pharmacovigilant point of view. We suggest that though the results of two-phase III double-blind clinical trials have been less than expected, tocilizumab has a real remaining potential to treat selected critical cases of COVID-19 beyond clinical trials until more data are revealed. On the contrary, remdesivir, though its FDA approval, and favipiravir are least likely to benefit COVID-19 patients. Moreover, we recommend that the RECOVERY dexamethasone should only be considered for critical hospitalized COVID-19 patients and we urge physicians in developing countries to avoid using it in mild-moderate COVID-19 cases. Finally, we recommend considering a personalized risk-benefit ratio before a decision is made using any of these drugs.