REDPINE
Trial question
What is the effect of remdesivir in hospitalized patients with COVID-19 pneumonia and renal impairment?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
43.0% female
57.0% male
N = 243
243 patients (104 female, 139 male).
Inclusion criteria: patients aged ≥ 12 years hospitalized for COVID-19 pneumonia with AKI, CKD, or kidney failure.
Key exclusion criteria: invasive or noninvasive mechanical ventilation; ECMO; dialysis for AKI.
Interventions
N=163 remdesivir (intravenous dose of 200 mg on day 1, followed by 100 mg daily on days 2-5).
N=80 placebo (matching intravenous saline placebo).
Primary outcome
Rate of death or invasive mechanical ventilation through day 29
29.4%
32.5%
32.5 %
24.4 %
16.3 %
8.1 %
0.0 %
Remdesivir
Placebo
No significant
difference ↔
No significant difference in the rate of death or invasive mechanical ventilation through day 29 (29.4% vs. 32.5%; HR 0.82, 95% CI 0.5 to 1.32).
Secondary outcomes
No significant difference in the rate of death by day 29 (25.2% vs. 28.8%; HR 0.83, 95% CI 0.5 to 1.39).
Safety outcomes
No significant difference in grade ≥ 3 adverse events and serious adverse events.
Conclusion
In patients aged ≥ 12 years hospitalized for COVID-19 pneumonia with AKI, CKD, or kidney failure, remdesivir was not superior to placebo with respect to the rate of death or invasive mechanical ventilation through day 29.
Reference
Meghan E Sise, Jose Ramon Santos, Jason D Goldman et al. Efficacy and Safety of Remdesivir in People With Impaired Kidney Function Hospitalized for COVID-19 Pneumonia: A Randomized Clinical Trial. Clin Infect Dis. 2024 Nov 22;79(5):1172-1181.
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