The safety and effectiveness of remdesivir in a postmarketing surveillance study in Japan

Respir Investig. 2024 Mar;62(2):192-199. doi: 10.1016/j.resinv.2023.12.016. Epub 2024 Jan 6.

Abstract

Background: To evaluate the occurrence of adverse drug reactions (ADRs) and to assess mortality and health status in participants receiving remdesivir in real-world settings in Japan.

Methods: This postmarketing surveillance study used an all-case surveillance method for enrollment. Participants with SARS-CoV-2 infection administered remdesivir from July 2020 to November 2021 in Japan were eligible for inclusion. The observation period was from remdesivir treatment initiation to 4 weeks after the end of treatment or treatment discontinuation. Clinical status and outcomes were analyzed by Kaplan-Meier plots and compared across subgroups at baseline, Day 14, Day 28, and the final observation point.

Results: The analysis included 2128 participants (mean age, 67 years; 71.4 % male; 84.1 % with current comorbidities). ADRs and serious adverse drug reactions (SADRs) were reported among 10.4 % and 1.2 % participants, respectively. Overall, 191/2127 participants died (mortality rate [95 % confidence interval], 11.10 [9.66-12.75] per 100 person-months), 1511/2127 showed clinical improvement (117.8 [112.0-123.9] per 100 person-months), 1392/2127 recovered (103.9 [98.6-110.0] per 100 person-months), and 216/324 were extubated (107.0 [93.6-122.3] per 100 person-months).

Conclusions: The incidence of ADRs and SADRs was low, and no new safety concerns were identified. Observed mortality and clinical improvement results were consistent with prior studies, confirming remdesivir's benefits in real-world settings in Japan.

Keywords: Antiviral therapy; COVID-19; Postmarketing surveillance; Real-world evidence; Remdesivir.

MeSH terms

  • Adenosine Monophosphate / adverse effects
  • Adenosine Monophosphate / analogs & derivatives*
  • Aged
  • Alanine / analogs & derivatives*
  • COVID-19*
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Product Surveillance, Postmarketing

Substances

  • remdesivir
  • Adenosine Monophosphate
  • Alanine