COVID-19 patients at two area hospitals first to receive trial nasal spray of antiviral drug remdesivir

Researchers at Baylor Scott & White are the first worldwide to try a new way to administer the antiviral drug remdesivir, which has been tested to help fight COVID-19 in some patients.

Before now, the drug has been administered through injections. Now, a group of patients in the Dallas area is getting the treatment through a nebulizer — which delivers medicine as a mist into the lungs. Using the device could eventually allow a patient to pick up a prescription for the drug at a local pharmacy for at-home use.

The trial will be conducted at Baylor University Medical Center at Dallas, Baylor Scott & White Medical Center at Irving and Baylor Scott & White Medical Center at College Station.

The new version of the drug also could help treat patients before they require hospitalization, which could reduce recovery times. Remdesivir has been shown to reduce the time to recovery, defined as being well enough to leave the hospital, by four days on average.

“We know antivirals work best when started early,” said Robert Gottlieb, a cardiologist and principal investigator of Baylor’s active COVID-19 treatment trials. “A patient is never giving themselves an IV at home, but they could pick up a nebulizer, go home and give themselves a breathing treatment.”

Remdesivir, which was developed by the pharmaceutical company Gilead to fight hepatitis C and the Ebola virus, has not been approved for widespread use against COVID-19, but it is being studied worldwide. Baylor Scott & White researchers already have helped evaluate its use through injections for COVID-19 patients.

The new study at Baylor Scott & White is examining whether different methods of administering remdesivir slow the coronavirus before patients become seriously ill. The trial is accepting patients within four days of their initial positive test who pass a physical screening.

The drug will be administered at emergency rooms at the participating hospitals for five consecutive days.

Gottlieb said the hospitals in Dallas, Irving and College Station were chosen because they have a diverse community need for COVID-19 treatments.

The two Dallas County hospitals were selected because of the county’s large case numbers, he said. In College Station, the drug could help university students and faculty members who may be at a higher risk of contracting the coronavirus.

The test will be randomized, blinded and placebo-controlled, which means patients and researchers will not know who receives the drug.

“There’s a great sense of reward when … [patients] feel they’re doing something good for themselves, as well as for others,” Gottlieb said. “If it does work, we want to get it to a larger group trial earlier to help more patients.”

Gottlieb said the trial is one of many at the hospital and worldwide working to fight COVID-19 in different ways.

Baylor hospitals in Round Rock and Fort Worth, for example, are studying antibody treatment. Even uninsured patients could be eligible for the experimental treatments.

“It’s the Wayne Gretzky model of COVID,” Gottlieb said, referring to the Hall of Fame hockey player. “If you don’t take a shot, generally you don’t score.”

Remdesivir is not available to the public and is being administered only in research trials such as the one at Baylor Scott & White.