geoffrey modest medical blogs

  the NY Times had another article by Rebecca Robbins on drug company shenanigans, this one on the delayed release of a superior form of tenofovir in the pursuit of profit (see  https://www.nytimes.com/2023/07/22/business/gilead-hiv-drug-tenofovir.html?smid=nytcore-ios-share&referringSource=articleShare  ).   Details : -- Gilead Sciences developed tenofovir disoproxyl fumarate (TDF), which became available in 2001 and was a game-changer for HIV treatment, the single best med at that time. it also was an excellent treatment for chronic hepatitis B infection -- unfortunately, there were a few important adverse effects well-known at the time: kidney failure and osteoporosis -- tenofovir alafenamide (TAF) was initially approved in 2016, as an upgrade, with similar benefits to TDF but significantly fewer renal or bone problems (TAF has much lower plasma concentrations than TDF)     But: -- in 2004, Gilead was developing a "next generation prodrug of ten...

  A new trial of remdesivir for treatment of patients with moderate Covid-19 pneumonia found a statistically significant difference in clinical status with the medication, though the difference was of uncertain clinical importance ( see  covid remdesivir review jama2020  in dropbox, or doi:10.1001/jama.2020.16349 )    Details: -- 580 for patients with confirmed SARS-CoV-2 infection by PCR and moderate Covid-19 pneumonia (pulmonary infiltrates and room air oxygen saturation >94%) were randomized to receive a 10-day course of remdesivir, a 5-day course of remdesivir, or standard care. Remdesivir was dosed at 200 mg on day one followed by 100 mg per day IV, in an open label trial in 105 hospitals in the US, Europe, and Asia between March 15 and April 18 -- median age 57, 39% women, 58% white/18% black/18% Asian/18% Hispanic, BMI 27, 84% were at clinical status 5 (see below) -- 56% had cardiovascular disease at baseline, 42% hypertension, 40% diabetes, and 1...