Remdesvir
Remdesivir is an investigational drug in trial for Ebola and COVID-19.
It is a phosphoraramidate nucleotide prodrug with the chemical formula:
Pyrrolo[2,1-f][triazin-4-amino] Adenine C-Nucleoside. It is said
has broad-spectrum in vitro activity against RNA viruses like
Ebola, Marburg, MERS-CoV, SARS-CoV. It becomes active after
phosphorylation to a triphosphate in the host’s cell. Remdesivir targets
the viral RNA-dependent RNA polymerase (RdRp) which is the complex
protein the coronaviruses use for the replication of their RNA genomes.
Its mechanism of action in human is not fully understood but in
vitro and non-human evidence suggests that it might be that it inhibits
RdRp thereby causing premature termination of viral RNA transcription
process leading to termination of the overall RNA synthesis (Tchesnokov
et al., 2019; Jordan et al., 2018; Brown et al., 2019; Amirian & Levy,
2020; Sheahan et al., 2020).
A recent preliminary report from one the clinical trial groups for
remdesvir suggests the drug caused 31% improvement in the days taken
for the recovery of COVID-19 patients (Nature, 2020).
The adverse effects of the drug will likely be emerging as the clinical
trials progress.