The World Health Organization has updated its ongoing guidance on Covid-19 medications to advise against using the antiviral drug remdesivir to treat hospitalized patients, no matter how severe their illness may be.

According to the update, published in the medical journal the BMJ on Thursday, current evidence does not suggest remdesivir affects the risk of dying from Covid-19 or needing mechanical ventilation, among other important outcomes.

WHO’s new update comes about a month after the company Gilead Sciences, the maker of remdesivir, announced that the US Food and Drug Administration approved remdesivir for the treatment of coronavirus infection. The drug became the first coronavirus treatment to receive FDA approval. 

Remdesivir may have received FDA approval but not WHO’s recommendation because of emerging research — which initially showed some benefit against Covid-19, but as more data accumulate, that appears to be changing, said Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, who was not involved in the WHO guidance. 

“We’ve seen people realize that the benefit of remdesivir is marginal at best — and the only benefit we had been touting was maybe it gets people better quicker. But the evidence base for that is weak, it’s not ironclad, and I think that’s what we’re seeing reflected in the WHO guidance, just more evaluation of the data that’s out there and more of now,” Adalja told CNN on Thursday.

“The fact that it was an antiviral that showed some benefit in certain trials — but not in all trials — was enough to push people to want to use it because we had no tools, but I do think it probably will be supplanted shortly,” Adalja said, adding that the indication for drugs can change over time.

Some context: WHO convened an international panel of 24 experts and four survivors of Covid-19 to review data and make recommendations. The recommendation against remdesivir was based on data from four randomized trials including 7,333 people hospitalized with Covid-19.

“The panel concluded that most patients would not prefer intravenous treatment with remdesivir given the low certainty evidence,” researchers from various institutions around the world wrote in the updated WHO guideline.

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