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“人民的希望”瑞德西韋正式獲FDA緊急授權(quán)應(yīng)用

5月1日,美國FDA根據(jù)“緊急授權(quán)應(yīng)用”(EUA)條款,正式批準了吉利德公司研制的抗病毒藥“瑞姆西韋”用于治療新冠病毒Covid-19感染患者(包括成人和兒童)。
正如業(yè)界專家評述“這是板上釘釘?shù)氖聝毫?/strong>”。
無論如何,該藥的安全性至少比羥氯喹要好得多。羥氯喹是上市用藥,臨床治療瘧疾或風濕性關(guān)節(jié)炎等,但用于治療新冠肺炎或Covid-19感染患者總是讓人心里不踏實。
然而,在國內(nèi)進行的“瑞姆西韋”臨床試驗結(jié)果卻沒有給出滿意或認可“結(jié)論”,這其中的客觀原因是什么?
WHO有關(guān)負責人也對此藥的臨床療效,或可否應(yīng)用于治療新冠肺炎/Covid-19病毒感染給出了不知可否的答復(fù)。
簡單講,同樣規(guī)范的臨床試驗設(shè)計(隨機、雙盲安慰劑對照),如果臨床療效評估終點指標和該藥應(yīng)用緊急狀況(目前疫情急迫窘?jīng)r)不同,也可能最終左右了FDA審評專家給出了【綠燈】“緊急授權(quán)應(yīng)用”。

FDA在其官方網(wǎng)站上發(fā)表的聲明如下:

“FDA’s emergency authorization of remdesivir, two days after the National Institutes of Health’s clinical trial showed promising results, is a significant step forward in battling COVID-19 and another example of the Trump Administration moving as quickly as possible to use science to save lives,” said HHS Secretary Alex Azar. 

“NIH, FDA, and scientists across America and around the world have worked tirelessly with patients to get us this new potential treatment for COVID-19. 

The seamless cooperation between government and private industry under the President’s all-of-America approach to COVID-19 is getting treatment options to patients in record time.”

The emergency use authorization allows for remdesivir to be distributed in the U.S. and administered intravenously by health care providers, as appropriate, to treat suspected or laboratory-confirmed COVID-19 in adults and children hospitalized with severe disease. 

Severe disease is defined as patients with low blood oxygen levels or needing oxygen therapy or more intensive breathing support such as a mechanical ventilator.

“From day one, the FDA has been committed to expediting the development and availability of potential COVID-19 treatments. Today’s action is an important step in our efforts to collaborate with innovators and researchers to provide sick patients timely access to new therapies where appropriate, while at the same time supporting research to further evaluate whether they are safe and effective,” said FDA Commissioner Stephen M. Hahn, M.D. 

“There’s tremendous interest among all parties to identify and arm ourselves with medicines to combat COVID-19, and through our Coronavirus Treatment Acceleration Program, the FDA is working around-the-clock and using every tool at our disposal to speed these efforts.”

Based on evaluation of the emergency use authorization criteria and the scientific evidence available, it was determined that it is reasonable to believe that remdesivir may be effective in treating COVID-19, and that, given there are no adequate, approved, or available alternative treatments, the known and potential benefits to treat this serious or life-threatening virus currently outweigh the known and potential risks of the drug’s use.

The EUA also requires that fact sheets that provide important information about using remdesivir in treating COVID-19 be made available to health care providers and patients, including dosing instructions, potential side effects and drug interactions. 

可能的不良反應(yīng)

Possible side effects of remdesivir include: increased levels of liver enzymes, which may be a sign of inflammation or damage to cells in the liver; and infusion-related reactions, which may include low blood pressure, nausea, vomiting, sweating, and shivering.

Following the declaration by the Secretary of HHS that circumstances exist justifying the emergency use of unapproved products, the FDA may issue an emergency use authorization to allow unapproved medical products or unapproved uses of approved medical products to be used in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions caused by chemical, biological, radiological and nuclear threats when there are no adequate, approved, and available alternatives.

The issuance of an EUA is different than FDA approval. In determining whether to issue an EUA, the FDA evaluates the available evidence and carefully balances any known or potential risks of any unproven products with any known or potential benefits of making them available during the emergency.

The EUA was issued to Gilead Sciences Inc. The FDA previously allowed for study of the investigational drug under clinical trials, as well as expanded access use for individual patients and through a multi-patient expanded access program coordinated by Gilead.

The EUA will be effective until the declaration that circumstances exist justifying the authorization of the emergency use of drugs and biologics for prevention and treatment of COVID-19 is terminated and may be revised or revoked if it is determined the EUA no longer meets the statutory criteria for issuance.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. 

The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.


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