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Editorial: Plusses and minuses to speedy Japan approval of Remdesivir to treat COVID-19

  • May 10, 2020
  • , The Mainichi
  • English Press

The Japanese government has granted the U.S.-made experimental antiviral drug Remdesivir extraordinarily quick approval for clinical use. The drug promises to help combat the novel coronavirus together with other measures to prevent transmissions, which is excellent news for medical facilities and virus patients. However, numerous issues remain to be resolved.


First of all, Remdesivir cannot be called a miracle medicine that will help all patients. In a clinical trial of about 1,000 COVID-19 patients, the drug was found to cut the recovery time by four days. If used appropriately, Remdesivir is expected to reduce the overwhelming demand for ventilators and ICU beds, and thus help head off a collapse of the medical system. However, it has not been confirmed that the drug reduces the virus’ mortality rate. Furthermore, as it is made in the United States, it is not known when it will be available for use in Japan and whether sufficient supplies can be obtained.


Care must also be taken over Remdesivir’s safety. It was originally under development as a treatment for Ebola hemorrhagic fever, also a viral disease. The U.S. government granted it emergency authorization due to the coronavirus crisis, and Tokyo in turn gave it “exceptional approval” in just three days. The approvals process usually takes about a year but, with a pressing need to prevent infections and no alternatives at hand, Japan decided to accept that the drug had met the standards of a foreign government. However, reported side effects include damage to kidney and liver functions. Careful and continuing collection and analysis of data is needed to determine whether the benefits of administering the drug outweigh the risks.


Meanwhile, the Japanese government is looking to approve a domestic drug called Avigan, originally developed to combat new influenza types. Clinical trials of Avigan to test its effectiveness against COVID-19 are now under way. There are reports of patients improving, and many more are clamoring to get the drug. However, the scientific testing process is not complete, and the medication has been shown to cause deformities in fetuses.


Also showing promise as COVID-19 treatments are ciclesonide (or Alvesco), an asthma drug, a pancreatitis medication called Nafamostat, and tocilizumab, a drug for rheumatism, among others. The more options we have in the coronavirus fight, the better. We hope that research into all these options continues steadily, without distortions.


Development and practical use of a vaccine, the ultimate weapon to stop the virus’ spread, is expected to take at least until next year, and perhaps longer. Until then, testing and appropriate use of existing medications is essential. And in tandem with this, extensive support should be provided for new drug development.

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